{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T04:11:55Z","timestamp":1768277515050,"version":"3.49.0"},"reference-count":42,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2023,8,9]],"date-time":"2023-08-09T00:00:00Z","timestamp":1691539200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004837","name":"Ministerio de Ciencia e Innovaci\u00f3n","doi-asserted-by":"publisher","award":["RTI2018-095994-B-I00"],"award-info":[{"award-number":["RTI2018-095994-B-I00"]}],"id":[{"id":"10.13039\/501100004837","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004837","name":"Ministerio de Ciencia e Innovaci\u00f3n","doi-asserted-by":"publisher","award":["AA16-0099-2"],"award-info":[{"award-number":["AA16-0099-2"]}],"id":[{"id":"10.13039\/501100004837","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004837","name":"Ministerio de Ciencia e Innovaci\u00f3n","doi-asserted-by":"publisher","award":["TED2021-132372B-I00"],"award-info":[{"award-number":["TED2021-132372B-I00"]}],"id":[{"id":"10.13039\/501100004837","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100014181","name":"Junta de Extremadura (Spain)","doi-asserted-by":"publisher","award":["RTI2018-095994-B-I00"],"award-info":[{"award-number":["RTI2018-095994-B-I00"]}],"id":[{"id":"10.13039\/501100014181","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100014181","name":"Junta de Extremadura (Spain)","doi-asserted-by":"publisher","award":["AA16-0099-2"],"award-info":[{"award-number":["AA16-0099-2"]}],"id":[{"id":"10.13039\/501100014181","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100014181","name":"Junta de Extremadura (Spain)","doi-asserted-by":"publisher","award":["TED2021-132372B-I00"],"award-info":[{"award-number":["TED2021-132372B-I00"]}],"id":[{"id":"10.13039\/501100014181","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004837","name":"Ministerio de Ciencia e Innovaci\u00f3n","doi-asserted-by":"publisher","award":["RTI2018-095994-B-I00"],"award-info":[{"award-number":["RTI2018-095994-B-I00"]}],"id":[{"id":"10.13039\/501100004837","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004837","name":"Ministerio de Ciencia e Innovaci\u00f3n","doi-asserted-by":"publisher","award":["AA16-0099-2"],"award-info":[{"award-number":["AA16-0099-2"]}],"id":[{"id":"10.13039\/501100004837","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004837","name":"Ministerio de Ciencia e Innovaci\u00f3n","doi-asserted-by":"publisher","award":["TED2021-132372B-I00"],"award-info":[{"award-number":["TED2021-132372B-I00"]}],"id":[{"id":"10.13039\/501100004837","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Noninvasive remote monitoring of hemodynamic variables is essential in optimizing treatment opportunities and predicting rehospitalization in patients with congestive heart failure. The objective of this study is to develop a wearable bioimpedance-based device, which can provide continuous measurement of cardiac output and stroke volume, as well as other physiological parameters for a greater prognosis and prevention of congestive heart failure. The bioimpedance system, which is based on a robust and cost-effective measuring principle, was implemented in a CMOS application specific integrated circuit, and operates as the analog front-end of the device, which has been provided with a radio-frequency section for wireless communication. The operating parameters of the proposed wearable device are remotely configured through a graphical user interface to measure the magnitude and the phase of complex impedances over a bandwidth of 1 kHz to 1 MHz. As a result of this study, a cardiac activity monitor was implemented, and its accuracy was evaluated in 33 patients with different heart diseases, ages, and genders. The proposed device was compared with a well-established technique such as Doppler echocardiography, and the results showed that the two instruments are clinically equivalent.<\/jats:p>","DOI":"10.3390\/s23167055","type":"journal-article","created":{"date-parts":[[2023,8,9]],"date-time":"2023-08-09T10:30:48Z","timestamp":1691577048000},"page":"7055","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Wearable and Noninvasive Device for Integral Congestive Heart Failure Management in the IoMT Paradigm"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6517-2047","authenticated-orcid":false,"given":"Jos\u00e9 L.","family":"Aus\u00edn","sequence":"first","affiliation":[{"name":"Department of Electrical, Electronics and Control Engineering, University of Extremadura, 06006 Badajoz, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier","family":"Ramos","sequence":"additional","affiliation":[{"name":"BioBee Technologies S.L., Extremadura Science and Technology Park, 06006 Badajoz, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Lorido","sequence":"additional","affiliation":[{"name":"BioBee Technologies S.L., Extremadura Science and Technology Park, 06006 Badajoz, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro","family":"Molina","sequence":"additional","affiliation":[{"name":"BioBee Technologies S.L., Extremadura Science and Technology Park, 06006 Badajoz, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0393-2893","authenticated-orcid":false,"given":"J. Francisco","family":"Duque-Carrillo","sequence":"additional","affiliation":[{"name":"Department of Electrical, Electronics and Control Engineering, University of Extremadura, 06006 Badajoz, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Dhaou, I.B., Ebrahimi, M., Ammar, M.B., Bouattour, G., and Kanoun, O. (2021). Edge devices for internet of medical things: Technologies, techniques, and implementation. Electronics, 10.","DOI":"10.3390\/electronics10172104"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"145248","DOI":"10.1109\/ACCESS.2021.3118960","article-title":"Smart healthcare in the age of AI: Recent advances, challenges, and future prospects","volume":"9","author":"Nasr","year":"2021","journal-title":"IEEE Access"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"107757:1","DOI":"10.1016\/j.measurement.2020.107757","article-title":"Analyzing patient health information based on IoT sensor with AI for improving patient assistance in the future direction","volume":"159","author":"Fouad","year":"2020","journal-title":"Measurement"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","article-title":"2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure","volume":"42","author":"McDonagh","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_5","unstructured":"(2022, November 07). An EU Action Plan for Better Cardiovascular Health. Available online: https:\/\/www.medtecheurope.org\/resource-library\/an-eu-action-plan-for-better-cardiovascular-health."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"12550","DOI":"10.1109\/JIOT.2020.3023105","article-title":"Automatic detection of congestive heart failure based on a hybrid deep learning algorithm in the internet of medical things","volume":"8","author":"Ning","year":"2021","journal-title":"IEEE Internet Things J."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"200","DOI":"10.3389\/fmed.2017.00200","article-title":"Non-invasive monitoring of cardiac output in critical care medicine","volume":"4","author":"Nguyen","year":"2017","journal-title":"Front. Med."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Grimnes, S., and Martinsen, \u00d8.G. (2015). Bioimpedance and Bioelectricity Basics, Academic Press. [3rd ed.].","DOI":"10.1016\/B978-0-12-411470-8.00011-8"},{"key":"ref_9","first-page":"9210258","article-title":"Fundamentals, Recent Advances, and Future Challenges in Bioimpedance Devices for Healthcare Applications","volume":"2019","author":"Min","year":"2019","journal-title":"J. Sens."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"22190","DOI":"10.1109\/JSEN.2021.3110283","article-title":"Bioimpedance Sensors: A Tutorial","volume":"21","author":"Kassanos","year":"2021","journal-title":"IEEE Sens. J."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Akay, M. (2006). Wiley Encyclopedia of Biomedical Engineering, Wiley.","DOI":"10.1002\/9780471740360"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Seoane, F., Ferreira, J., Buendia, R., and Lindecrantz, K. (September, January 28). Adaptive frequency distribution for electrical bioimpedance spectroscopy measurements. Proceedings of the 2012 Annual International Conference of the IEEE Engineering in Medicine and Biology Society, San Diego, CA, USA.","DOI":"10.1109\/EMBC.2012.6345993"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"550","DOI":"10.5603\/CJ.2012.0104","article-title":"Impedance cardiography: Recent advancements","volume":"19","author":"Cybulski","year":"2012","journal-title":"Cardiol. J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"03TR01","DOI":"10.1088\/1361-6579\/abe80e","article-title":"Bioimpedance analysis as a tool for hemodynamic monitoring: overview, methods and challenges","volume":"42","author":"Anand","year":"2021","journal-title":"Physiol. Meas."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1007\/BF02344724","article-title":"Stroke volume equation for impedance cardiography","volume":"43","author":"Bernstein","year":"2005","journal-title":"Med. Biol. Eng. Comput."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1088\/0967-3334\/35\/6\/917","article-title":"Bioelectrical impedance spectroscopy as a fluid management system in heart failure","volume":"35","author":"Weyer","year":"2014","journal-title":"Physiol. Meas."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e22911","DOI":"10.2196\/22911","article-title":"Wearable Bioimpedance Monitoring: Viewpoint for Application in Chronic Conditions","volume":"6","author":"Groenendaal","year":"2021","journal-title":"JMIR Biomed. Eng."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"9545","DOI":"10.1109\/JIOT.2019.2929459","article-title":"Standalone IoT Bioimpedance Device Supporting Real-Time Online Data Access","volume":"6","author":"Vela","year":"2019","journal-title":"IEEE Internet Things J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"189","DOI":"10.4103\/aca.ACA_1_19","article-title":"Comparison of continuous cardiac output monitoring derived from regional impedance cardiography with continuous thermodilution technique in cardiac surgical patients","volume":"23","author":"Singh","year":"2020","journal-title":"Ann. Card. Anaesth."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Piccirillo, G., Moscucci, F., Corrao, A., Carnovale, M., Di Diego, I., Lospinuso, I., Caltabiano, C., Mezzadri, M., Rossi, P., and Magr\u00ec, D. (2022). Noninvasive Hemodynamic Monitoring in Advanced Heart Failure Patients: New Approach for Target Treatments. Biomedicines, 10.","DOI":"10.3390\/biomedicines10102407"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1007\/s11897-020-00467-x","article-title":"The Role of Wearables in Heart Failure","volume":"17","author":"Singhal","year":"2020","journal-title":"Curr. Hear. Fail. Rep."},{"key":"ref_22","unstructured":"(2023, March 01). ToSense Home Page. Available online: https:\/\/healthtecsol.com\/tosense-cova2\/."},{"key":"ref_23","unstructured":"(2023, March 01). Zoll Medical Home Page. Available online: https:\/\/cardiacdiagnostics.zoll.com\/products\/heart-failure-arrhythmia-management-system."},{"key":"ref_24","unstructured":"(2023, March 02). PhysioFlow Home Page. Available online: https:\/\/www.physioflow.com\/products_physioflow.php."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"824","DOI":"10.1109\/10.238468","article-title":"Bioelectric impedance measurements using synchronous sampling","volume":"40","author":"Webster","year":"1993","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Shin, S., Jung, Y., Kweon, S.-J., Lee, E., Park, J.-H., Kim, J., Yoo, H.-J., and Je, M. (2020). Design of Reconfigurable Time-to-Digital Converter Based on Cascaded Time Interpolators for Electrical Impedance Spectroscopy. Sensors, 20.","DOI":"10.3390\/s20071889"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1109\/TBCAS.2020.3012057","article-title":"Time Stamp\u2014A Novel Time-to-Digital Demodulation Method for Bioimpedance Implant Applications","volume":"14","author":"Wu","year":"2020","journal-title":"IEEE Trans. Biomed. Circuits Syst."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1108","DOI":"10.1109\/TBCAS.2020.3025218","article-title":"A Wearable CMOS Impedance to Frequency Sensing System for Non-Invasive Impedance Measurements","volume":"14","author":"Hedayatipour","year":"2020","journal-title":"IEEE Trans. Biomed. Circuits Syst."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.1088\/0967-3334\/27\/12\/004","article-title":"Design and preliminary evaluation of a portable device for the measurement of bioimpedance spectroscopy","volume":"27","author":"Yang","year":"2006","journal-title":"Physiol. Meas."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Ben Atitallah, B., Kallel, A.Y., Bouchaala, D., Derbel, N., and Kanoun, O. (2022). Comparative Study of Measurement Methods for Embedded Bioimpedance Spectroscopy Systems. Sensors, 22.","DOI":"10.3390\/s22155801"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2229","DOI":"10.1109\/JSEN.2013.2251628","article-title":"A CMOS Magnitude\/Phase Measurement Chip for Impedance Spectroscopy","volume":"13","author":"Kassanos","year":"2013","journal-title":"IEEE Sens. J."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Kweon, S.-J., Shin, S., Park, J.-H., Suh, J.-H., and Yoo, H.-J. (2016, January 17\u201319). A CMOS Low-Power Polar Demodulator for Electrical Bioimpedance Spectroscopy Using Adaptive Self-Sampling Schemes. Proceedings of the IEEE Biomedical Circuits and Systems Conference (BioCAS 2016), Shanghai, China.","DOI":"10.1109\/BioCAS.2016.7833787"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1210","DOI":"10.1109\/TBCAS.2021.3135836","article-title":"A Polar-Demodulation-Based Impedance-Measurement IC Using Frequency-Shift Technique with Low Power Consumption and Wide Frequency Range","volume":"15","author":"Cheon","year":"2021","journal-title":"IEEE Trans. Biomed. Circuits Syst."},{"key":"ref_34","unstructured":"Ramos, J., Aus\u00edn, J.L., Duque-Carrillo, J.F., and Torelli, G. (2010, January 18\u201321). A 1-MHz Analog Front-End for a Wireless Bioelectrical Impedance Sensor. Proceedings of the 6th Conference on Ph.D. Research in Microelectronics & Electronics (PRIME 2010), Berlin, Germany."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"904","DOI":"10.1016\/j.mejo.2012.12.011","article-title":"Design tradeoffs for sub-mW CMOS biomedical limiting amplifiers","volume":"44","author":"Ramos","year":"2013","journal-title":"Microelectron. J."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1007\/s10470-011-9820-5","article-title":"Analysis and design of the true piecewise approximation logarithmic amplifiers","volume":"72","author":"Shaterian","year":"2012","journal-title":"Analog. Integr. Circuits Signal Process."},{"key":"ref_37","unstructured":"(2020). CC13x0, CC26x0 SimpleLinkTM Wireless MCU, Texas Instruments."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1016\/j.cjca.2023.01.012","article-title":"New Developments in Continuous Hemodynamic Monitoring of the Critically Ill Patient","volume":"39","author":"Couture","year":"2023","journal-title":"Can. J. Cardiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"139","DOI":"10.2478\/joeb-2019-0020","article-title":"Age-related differences in the morphology of the impedance cardiography signal","volume":"10","author":"Tronstad","year":"2019","journal-title":"J. Electr. Bioimpedance"},{"key":"ref_40","first-page":"709","article-title":"A New Biometrical Procedure for Testing the Equality of Measurements from Two Different Analytical Methods. Application of linear regression procedures for method comparison studies in Clinical Chemistry, Part I","volume":"21","author":"Passing","year":"1983","journal-title":"J. Clin. Chem. Clin. Biochem."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1515\/cclm.1984.22.6.431","article-title":"Comparison of Several Regression Procedures for Method Comparison Studies and Determination of Sample Sizes Application of linear regression procedures for method comparison studies in Clinical Chemistry, Part II","volume":"22","author":"Passing","year":"1984","journal-title":"Clin. Chem. Lab. Med."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Urban, M., Klum, M., Pielmus, A.-G., Liebrenz, F., Mann, S., Tigges, T., and Orglmeister, R. (2022). GRU Neural Network Improved Bioimpedance Based Stroke Volume Estimation during Ergometry Stress Test. Sensors, 22.","DOI":"10.3390\/s22207883"}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/23\/16\/7055\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:29:54Z","timestamp":1760128194000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/23\/16\/7055"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,9]]},"references-count":42,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2023,8]]}},"alternative-id":["s23167055"],"URL":"https:\/\/doi.org\/10.3390\/s23167055","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,9]]}}}