Noninvasive Assessment of Cardiac Output in Advanced Heart Failure and Heart Transplant Candidates Using the Bioreactance Method

Bashar A W Pandhita, Nduka C Okwose, Aaron Koshy, Óscar G Fernández, Noelia B Cruz, Christopher Eggett, Lazar Velicki, Dejana Popovic, Guy A MacGowan, Djordje G Jakovljevic

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OBJECTIVES: The aim of the present study was to assess the validity and trending ability of the bioreactance method in estimating cardiac output at rest and in response to stress in advanced heart failure patients and heart transplant candidates.

DESIGN: This was a prospective single-center study.

SETTING: This study was conducted at the heart transplant center at the Freeman Hospital, Newcastle upon Tyne, UK.

PARTICIPANTS: Eighteen patients with advanced chronic heart failure due to reduced left ventricular ejection fraction (19 ± 7%), and peak oxygen consumption 12.3 ± 3.9 mL/kg/min.

INTERVENTIONS: Participants underwent right heart catheterization using the Swan-Ganz catheter.

MEASUREMENTS AND MAIN RESULTS: Cardiac output was measured simultaneously using thermodilution and bioreactance at rest and during active straight leg raise test to volitional exertion. There was no significant difference in cardiac index values obtained by the thermodilution and bioreactance methods (2.26 ± 0.59 v 2.38 ± 0.50 L/min, p > 0.05) at rest and peak straight leg raise test (2.92 ± 0.77 v 3.01 ± 0.66 L/min, p > 0.05). In response to active leg raise test, thermodilution cardiac output increased by 22% and bioreactance by 21%. There was also a strong relationship between cardiac outputs from both methods at rest (r = 0.88, p < 0.01) and peak straight leg raise test (r = 0.92, p < 0.01). Cartesian plot analysis showed good trending ability of bioreactance compared with thermodilution (concordance rate = 93%) CONCLUSIONS: `Cardiac output measured by the bioreactance method is comparable to that from the thermodilution method. Bioreactance method may be used in clinical practice to assess hemodynamics and improve management of advanced heart failure patients undergoing heart transplant assessment.

Original languageEnglish
Pages (from-to)1776-1781
Number of pages6
JournalJournal of Cardiothoracic and Vascular Anesthesia
Issue number6
Early online date20 Sept 2020
Publication statusPublished - Jun 2021
Externally publishedYes

Bibliographical note

NOTICE: this is the author’s version of a work that was accepted for publication in Journal of Cardiothoracic and Vascular Anesthesia (JCVA). Changes resulting from the publishing process, such as peer review, editing, corrections, structural
formatting, and other quality control mechanisms may not be reflected in this
document. Changes may have been made to this work since it was submitted for
publication. A definitive version was subsequently published in Journal of
Cardiothoracic and Vascular Anesthesia (JCVA), 35, 6, (2020) DOI:

© 2020, Elsevier. Licensed under the Creative Commons AttributionNonCommercial-NoDerivatives 4.0 International


  • bioreactance
  • cardiac monitoring
  • cardiac output
  • heart failure
  • thermodilution

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Anesthesiology and Pain Medicine


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