{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T02:04:42Z","timestamp":1792807482949,"version":"4.5.0"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100014440","name":"Ministry of Science, Innovation and Universities","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014440","id-type":"DOI","asserted-by":"publisher"}]},{"name":"CIBER Cardiovascular","award":["16\/11\/00420"],"award-info":[{"award-number":["16\/11\/00420"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Novel bioimpedance analysis (BIA) devices may improve the precision of fluid overload assessment, potentially offering additional prognostic information beyond clinical parameters in patients with HF. This study aimed to evaluate the association between fluid overload indexes obtained with a novel bioelectrical impedance device (BioScan touch i8 IVF, MALTRON\u00ae) and the risk of cardiovascular events in ambulatory patients with HF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Volume excess was assessed using BioScan Touch i8 IVF (MALTRON), which differentiates fluid distribution across body compartments. Volume-excess variables (total, intravascular, and tissue) were analysed both as quartiles (Q) and as continuous measures. Their independent associations with the composite of all-cause death or worsening HF were adjusted for established prognostic markers, including a clinical congestion score (CCS) and N-terminal pro-B-type natriuretic peptide.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 386 ambulatory patients with stage C chronic HF, median total, intravascular, and tissue fluid excess were 1.3 L (Q1\u2013Q3: 0.5, 2.3), 0.1 L (Q1\u2013Q3: \u22120.1, 0.4), and 1.9 L (Q1\u2013Q3: 1.1, 2.8), respectively. Total and tissue fluid excess had the strongest correlation with the CCS (Total fluid excess rho = 0.31; P &amp;lt; .001, tissue fluid excess rho = 0.33; P &amp;lt; .001). In adjusted analyses, patients in the highest quartile had significantly higher risk of the composite outcome compared with Q1: total fluid excess hazard ratio (HR) 2.11 [95% confidence interval (CI) 1.21\u20134.05, P = .010], intravascular fluid excess HR 2.16 (1.19\u20133.90, P = .011), and tissue fluid excess HR 2.81 (1.49\u20135.32, P = .001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Compartment-specific estimates of fluid overload obtained with the BioScan Touch i8 IVF were independently associated with adverse outcomes in ambulatory patients with chronic HF, beyond NT-proBNP and clinical surrogates of congestion. These findings support the potential role of BIA-derived indexes, particularly tissue fluid excess, as complementary tools for risk stratification in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eschf\/xvag002","type":"journal-article","created":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T12:44:37Z","timestamp":1767789877000},"source":"Crossref","is-referenced-by-count":2,"title":["Bioimpedance-derived compartmental fluid status and prognosis in chronic heart failure"],"prefix":"10.1093","volume":"13","author":[{"given":"Jorge","family":"Montiel","sequence":"first","affiliation":[{"name":"Cardiology Department, Hospital Cl\u00ednico Universitario de Valencia , Avda. Blasco Ib\u00e1\u00f1ez 17, Valencia 46010 ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia","family":"Lucas","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Hospital Cl\u00ednico Universitario de Valencia , Valencia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Peir\u00f3","sequence":"additional","affiliation":[{"name":"Department of Medicine, Universitat de Val\u00e8ncia , Valencia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gonzalo","family":"N\u00fa\u00f1ez","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Cl\u00ednico Universitario de Valencia , Avda. Blasco Ib\u00e1\u00f1ez 17, Valencia 46010 ,","place":["Spain"]},{"name":"INCLIVA Biomedical Research Institute , Valencia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9182-4459","authenticated-orcid":false,"given":"Miguel","family":"Lorenzo","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Cl\u00ednico Universitario de Valencia , Avda. Blasco Ib\u00e1\u00f1ez 17, Valencia 46010 ,","place":["Spain"]},{"name":"INCLIVA Biomedical Research Institute , Valencia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Gasull","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Cl\u00ednico Universitario de Valencia , Avda. Blasco Ib\u00e1\u00f1ez 17, Valencia 46010 ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8777-2588","authenticated-orcid":false,"given":"Gema","family":"Mi\u00f1ana","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Cl\u00ednico Universitario de Valencia , Avda. Blasco Ib\u00e1\u00f1ez 17, Valencia 46010 ,","place":["Spain"]},{"name":"Department of Medicine, Universitat de Val\u00e8ncia , Valencia ,","place":["Spain"]},{"name":"INCLIVA Biomedical Research Institute , Valencia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Mollar","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Cl\u00ednico Universitario de Valencia , Avda. Blasco Ib\u00e1\u00f1ez 17, Valencia 46010 ,","place":["Spain"]},{"name":"INCLIVA Biomedical Research Institute , Valencia ,","place":["Spain"]},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red\u2014Cardiovascular (CIBER-CV) , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrique","family":"Santas","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Cl\u00ednico Universitario de Valencia , Avda. Blasco Ib\u00e1\u00f1ez 17, Valencia 46010 ,","place":["Spain"]},{"name":"Department of Medicine, Universitat de Val\u00e8ncia , Valencia ,","place":["Spain"]},{"name":"INCLIVA Biomedical Research Institute , Valencia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Luis","family":"G\u00f3rriz","sequence":"additional","affiliation":[{"name":"Department of Medicine, Universitat de Val\u00e8ncia , Valencia ,","place":["Spain"]},{"name":"INCLIVA Biomedical Research Institute , Valencia ,","place":["Spain"]},{"name":"Nephrology Department, Hospital Cl\u00ednico Universitario de Valencia , Valencia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0797-8709","authenticated-orcid":false,"given":"Juan","family":"Sanchis","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Cl\u00ednico Universitario de Valencia , Avda. Blasco Ib\u00e1\u00f1ez 17, Valencia 46010 ,","place":["Spain"]},{"name":"Department of Medicine, Universitat de Val\u00e8ncia , Valencia ,","place":["Spain"]},{"name":"INCLIVA Biomedical Research Institute , Valencia ,","place":["Spain"]},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red\u2014Cardiovascular (CIBER-CV) , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julio","family":"N\u00fa\u00f1ez","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Cl\u00ednico Universitario de Valencia , Avda. Blasco Ib\u00e1\u00f1ez 17, Valencia 46010 ,","place":["Spain"]},{"name":"Department of Medicine, Universitat de Val\u00e8ncia , Valencia ,","place":["Spain"]},{"name":"INCLIVA Biomedical Research Institute , Valencia ,","place":["Spain"]},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red\u2014Cardiovascular (CIBER-CV) , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8720-3999","authenticated-orcid":false,"given":"Rafael","family":"de la Espriella","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Cl\u00ednico Universitario de Valencia , Avda. Blasco Ib\u00e1\u00f1ez 17, Valencia 46010 ,","place":["Spain"]},{"name":"INCLIVA Biomedical Research Institute , Valencia ,","place":["Spain"]},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red\u2014Cardiovascular (CIBER-CV) , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,1,22]]},"reference":[{"key":"2026021713114533300_xvag002-B1","doi-asserted-by":"publisher","first-page":"1076","DOI":"10.1093\/eurjhf\/hfq154","article-title":"EURObservational research programme: the heart failure pilot survey (ESC-HF pilot)","volume":"12","author":"Maggioni","year":"2010","journal-title":"Eur J Heart Fail"},{"key":"2026021713114533300_xvag002-B2","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1002\/ejhf.1369","article-title":"The use of diuretics in heart failure with congestion\u2014a position statement from the Heart Failure Association of the European Society of Cardiology","volume":"21","author":"Mullens","year":"2019","journal-title":"Eur J Heart Fail"},{"key":"2026021713114533300_xvag002-B3","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1016\/j.recesp.2022.08.001","article-title":"Assessment of filling pressures and fluid overload in heart failure: an updated perspective","volume":"76","author":"De la Espriella","year":"2023","journal-title":"Rev Espanola Cardiol"},{"key":"2026021713114533300_xvag002-B4","doi-asserted-by":"publisher","first-page":"1751","DOI":"10.1002\/ejhf.2664","article-title":"Congestion in heart failure: a circulating biomarker-based perspective. A review from the Biomarkers Working Group of the Heart Failure Association, European Society of Cardiology","volume":"24","author":"N\u00fa\u00f1ez","year":"2022","journal-title":"Eur J Heart Fail"},{"key":"2026021713114533300_xvag002-B5","doi-asserted-by":"publisher","first-page":"616","DOI":"10.1002\/ejhf.2848","article-title":"Natriuretic peptides: role in the diagnosis and management of heart failure: a scientific statement from the Heart Failure Association of the European Society of Cardiology, Heart Failure Society of America and Japanese Heart Failure Society","volume":"25","author":"Tsutsui","year":"2023","journal-title":"Eur J Heart Fail"},{"key":"2026021713114533300_xvag002-B6","doi-asserted-by":"publisher","first-page":"703","DOI":"10.1002\/ejhf.2032","article-title":"Ultrasound imaging of congestion in heart failure: examinations beyond the heart","volume":"23","author":"Pellicori","year":"2021","journal-title":"Eur J Heart Fail"},{"key":"2026021713114533300_xvag002-B7","doi-asserted-by":"publisher","first-page":"304","DOI":"10.1016\/j.jchf.2023.07.015","article-title":"Intrarenal venous flow pattern changes do relate with renal function alterations in acute heart failure","volume":"12","author":"De la Espriella","year":"2024","journal-title":"JACC Heart Fail"},{"key":"2026021713114533300_xvag002-B8","doi-asserted-by":"publisher","first-page":"1129","DOI":"10.1016\/j.echo.2025.08.011","article-title":"Modified venous excess ultrasound: a dynamic tool to predict mortality in acute decompensated heart failure","volume":"38","author":"Saadi","year":"2025","journal-title":"J Am Soc Echocardiogr"},{"key":"2026021713114533300_xvag002-B9","doi-asserted-by":"publisher","first-page":"1628","DOI":"10.1016\/j.cardfail.2022.08.005","article-title":"Bioimpedance indices of fluid overload and cardiorenal outcomes in heart failure and chronic kidney disease: a systematic review","volume":"28","author":"Mayne","year":"2022","journal-title":"J Card Fail"},{"key":"2026021713114533300_xvag002-B10","doi-asserted-by":"publisher","first-page":"e006817","DOI":"10.1161\/JAHA.117.006817","article-title":"Role of volume redistribution in the congestion of heart failure","volume":"6","author":"Fudim","year":"2017","journal-title":"J Am Heart Assoc"},{"key":"2026021713114533300_xvag002-B11","doi-asserted-by":"publisher","first-page":"776","DOI":"10.1002\/ejhf.2874","article-title":"Worsening of chronic heart failure: definition, epidemiology, management and prevention. A clinical consensus statement by the Heart Failure Association of the European Society of Cardiology","volume":"25","author":"Metra","year":"2023","journal-title":"Eur J Heart Fail"},{"key":"2026021713114533300_xvag002-B12","doi-asserted-by":"publisher","first-page":"476","DOI":"10.1016\/j.ijcard.2016.12.080","article-title":"Fluid status and outcome in patients with heart failure and preserved ejection fraction","volume":"230","author":"Koell","year":"2017","journal-title":"Int J Cardiol"},{"key":"2026021713114533300_xvag002-B13","doi-asserted-by":"publisher","first-page":"901","DOI":"10.1016\/j.nut.2011.11.033","article-title":"Bioelectrical impedance phase angle as a prognostic marker in chronic heart failure","volume":"28","author":"Col\u00edn-Ram\u00edrez","year":"2012","journal-title":"Nutrition"},{"key":"2026021713114533300_xvag002-B14","doi-asserted-by":"publisher","first-page":"1530","DOI":"10.1016\/j.clnu.2016.04.007","article-title":"Prognostic role of phase angle in hospitalized patients with acute decompensated heart failure","volume":"35","author":"Alves","year":"2016","journal-title":"Clin Nutr"},{"key":"2026021713114533300_xvag002-B15","doi-asserted-by":"publisher","first-page":"2616","DOI":"10.1253\/circj.CJ-15-0723","article-title":"Quantitative assessment of fluid accumulation using bioelectrical impedance analysis in patients with acute decompensated heart failure","volume":"79","author":"Sakaguchi","year":"2015","journal-title":"Circ J"},{"key":"2026021713114533300_xvag002-B16","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1177\/2048872616641281","article-title":"Prognostic value of decreased peripheral congestion detected by Bioelectrical Impedance Vector Analysis (BIVA) in patients hospitalized for acute heart failure: BIVA prognostic value in acute heart failure","volume":"6","author":"Santarelli","year":"2017","journal-title":"Eur Heart J Acute Cardiovasc Care"},{"key":"2026021713114533300_xvag002-B17","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1097\/HPC.0000000000000105","article-title":"Noninvasive bioelectrical impedance for predicting clinical outcomes in outpatients with heart failure","volume":"16","author":"Lyons","year":"2017","journal-title":"Crit Pathw Cardiol"},{"key":"2026021713114533300_xvag002-B18","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1007\/s11897-006-0013-y","article-title":"Bioimpedance to prevent heart failure hospitalization","volume":"3","author":"Albert","year":"2006","journal-title":"Curr Heart Fail Rep"},{"key":"2026021713114533300_xvag002-B19","doi-asserted-by":"publisher","first-page":"1254","DOI":"10.1016\/j.amjcard.2004.01.070","article-title":"Relation of unrecognized hypervolemia in chronic heart failure to clinical status, hemodynamics, and patient outcomes","volume":"93","author":"Androne","year":"2004","journal-title":"Am J Cardiol"},{"key":"2026021713114533300_xvag002-B20","doi-asserted-by":"publisher","first-page":"705","DOI":"10.1080\/03007995.2018.1519502","article-title":"Comparison between inferior vena cava ultrasound, lung ultrasound, bioelectric impedance analysis, and natriuretic peptides in chronic heart failure","volume":"35","author":"Curbelo","year":"2019","journal-title":"Curr Med Res Opin"},{"key":"2026021713114533300_xvag002-B21","doi-asserted-by":"publisher","first-page":"662","DOI":"10.1053\/j.ajkd.2018.03.030","article-title":"Bioelectrical impedance analysis measures and clinical outcomes in CKD","volume":"72","author":"Bansal","year":"2018","journal-title":"Am J Kidney Dis"},{"key":"2026021713114533300_xvag002-B22","doi-asserted-by":"publisher","first-page":"e001918","DOI":"10.1161\/JAHA.115.001918","article-title":"Volume overload and adverse outcomes in chronic kidney disease: clinical observational and animal studies","volume":"4","author":"Hung","year":"2015","journal-title":"J Am Heart Assoc"},{"key":"2026021713114533300_xvag002-B23","doi-asserted-by":"publisher","first-page":"108754","DOI":"10.1016\/j.diabres.2021.108754","article-title":"Association of overhydration and serum pigment epithelium-derived factor with CKD progression in diabetic kidney disease: a prospective cohort study","volume":"174","author":"Liu","year":"2021","journal-title":"Diabetes Res Clin Pract"},{"key":"2026021713114533300_xvag002-B24","doi-asserted-by":"publisher","first-page":"1304","DOI":"10.1016\/j.kint.2019.02.022","article-title":"Heart failure in chronic kidney disease: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference","volume":"95","author":"House","year":"2019","journal-title":"Kidney Int"},{"key":"2026021713114533300_xvag002-B25","doi-asserted-by":"publisher","first-page":"1848","DOI":"10.1136\/heartjnl-2016-310794","article-title":"Heart failure in patients with kidney disease","volume":"103","author":"Tuegel","year":"2017","journal-title":"Heart"},{"key":"2026021713114533300_xvag002-B26","doi-asserted-by":"publisher","first-page":"1574","DOI":"10.1093\/ndt\/gfn707","article-title":"The mortality risk of overhydration in haemodialysis patients","volume":"24","author":"Wizemann","year":"2009","journal-title":"Nephrol Dial Transplant"},{"key":"2026021713114533300_xvag002-B27","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1007\/s11255-016-1471-0","article-title":"Dry weight assessment by combined ultrasound and bioimpedance monitoring in low cardiovascular risk hemodialysis patients: a randomized controlled trial","volume":"49","author":"Siriopol","year":"2017","journal-title":"Int Urol Nephrol"},{"key":"2026021713114533300_xvag002-B28","doi-asserted-by":"publisher","first-page":"957","DOI":"10.1053\/j.ajkd.2012.12.017","article-title":"Effect of fluid management guided by bioimpedance spectroscopy on cardiovascular parameters in hemodialysis patients: a randomized controlled trial","volume":"61","author":"Hur","year":"2013","journal-title":"Am J Kidney Dis"}],"container-title":["ESC Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/eschf\/advance-article-pdf\/doi\/10.1093\/eschf\/xvag002\/66534230\/xvag002.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/13\/1\/xvag002\/66534230\/xvag002.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/13\/1\/xvag002\/66534230\/xvag002.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T18:11:55Z","timestamp":1771351915000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eschf\/article\/doi\/10.1093\/eschf\/xvag002\/8436900"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,22]]},"references-count":28,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,22]]},"published-print":{"date-parts":[[2026,2,3]]}},"URL":"https:\/\/doi.org\/10.1093\/eschf\/xvag002","relation":{},"ISSN":["2055-5822"],"issn-type":[{"value":"2055-5822","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,2]]},"published":{"date-parts":[[2026,1,22]]},"article-number":"xvag002"}}