{"id":"d796174382d2","type":"article","url":"https://hartvaat.nl/2026/09/23/bioimpedancemeting-als-hulpmiddel-bij-congestie-bij-hartfalen/","title":"Bioimpedancemeting als hulpmiddel bij congestie bij hartfalen","title_en":"Bioimpedance utility in heart failure.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog","internist"],"tags":[],"journal":"Heart failure reviews","doi":"10.1007/s10741-026-10681-9","source_url":"https://doi.org/10.1007/s10741-026-10681-9","authors":["Archana Ganapathy","Jason N Dungu","Anthony D Dimarco","Andrew Chisom Madu","Samantha Langley","Peter Watters","Henry Oluwasefunmi Savage"],"significance":5,"published":"2026-10-01","source_date":"2026-09-23","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/hartfalen-stadiumindeling-nyha/","https://hartvaat.nl/kennis/diagnostiek/transthoracale-echocardiografie/"],"congress":"","summary_en":"Congestion remains a major driver of symptoms and prognosis in heart failure, yet its assessment is hampered by the limitations of conventional clinical and imaging tools. This narrative review examines the physiological principles and clinical applications of bioimpedance analysis (BIA) for evaluating fluid distribution, including its potential in diagnosis, prognostication, therapeutic guidance, and remote monitoring. While advances in multifrequency and segmental systems show promise, methodological heterogeneity and a lack of robust clinical evidence currently limit widespread adoption. The authors highlight key evidence gaps and the need for standardized protocols before BIA can be reliably integrated into routine heart failure care.","created":"2026-09-24T01:19:41Z","updated":"2026-09-24T01:19:41Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Congestie is een centrale drijfveer van symptomen en prognose bij hartfalen, maar de beoordeling ervan blijft lastig door beperkingen van conventionele methoden. Deze narratieve review beschrijft de fysiologische principes en klinische toepassingen van bioimpedantieanalyse (BIA) voor het monitoren van vochtverdeling, waaronder diagnose, prognose, therapieaanpassing en remote monitoring. Hoewel multifrequente en segmentale systemen veelbelovend zijn, blijven methodologische inconsistenties en een gebrek aan robuust klinisch bewijs de brede integratie in de dagelijkse praktijk beperken. De review benadrukt de noodzaak van gestandaardiseerde protocollen en grootschalige studies voordat BIA als routinehulpmiddel kan worden ingezet.","abstract_original":"Congestion is a central pathophysiological feature of heart failure (HF) and a major contributor to symptoms and prognosis. Despite the substantial mortality benefit of disease-modifying therapies [1], assessing and managing congestion remains challenging. Existing tools such as clinical examination, blood and urinary biomarkers, and cardiac and lung ultrasound are limited by observer variability, logistical constraints and the need for technical expertise [2]. Comorbidities such as chronic kidney disease (CKD), which co-exist in up to 60% of patients with heart failure and may contribute to congestion, further complicate assessments, which can lead to worse outcomes [3, 4]. Consequently, there is growing interest in objective, reproducible and accessible tools that complement conventional approaches to congestion assessment by providing additional information on fluid distribution within body compartments. Bioimpedance analysis (BIA) is a non-invasive technique that measures the electrical properties of biological tissues to estimate body composition and fluid distribution. Since the pioneering work of Nyboer in 1959 and Hoffer et al. in 1969 [5], BIA has evolved from a research tool for body composition into a broader clinical technology used across multiple specialties [6]. Advances in multifrequency, segmental, and spectroscopy-based systems have further expanded its potential for assessing fluid compartments in conditions such as HF and Chronic Kidney Disease (CKD). However, BIA encompasses heterogeneous technologies, parameters and prediction models, and its clinical role remains incompletely defined, with recommendations for further research [7]. This narrative review outlines the physiological principles of bioimpedance, evaluates its applications in HF diagnosis, prognostication, therapeutic guidance and remote monitoring, and explores the methodological and clinical barriers that have restricted its widespread adoption. We discuss its potential as an adjunctive tool for assessing congestion and highlight the key evidence gaps that must be addressed before bioimpedance can be more widely integrated into routine HF care."}