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临床校准在提高家庭远程监测的参与度和应用方面的潜在作用:来自HeartCycle项目的报告。

Potential role for clinical calibration to increase engagement with and application of home telemonitoring: a report from the HeartCycle programme.

作者信息

Gastelurrutia Paloma, Lupón Josep, Domingo Mar, Stut Wim, Dovancescu Silviu, Cleland John, Frankenstein Lutz, Bayes-Genis Antoni

机构信息

ICREC Research Program Fundació Institut d´Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP) Badalona Spain.

Cardiology ServiceHospital Universitari Germans Trias i PujolBadalonaSpain; Department of MedicineUniversitat Autònoma de BarcelonaBarcelonaSpain.

出版信息

ESC Heart Fail. 2017 Feb;4(1):66-70. doi: 10.1002/ehf2.12104. Epub 2016 Jul 28.

Abstract

AIMS

There is a need for alternative strategies that might avoid recurrent admissions in patients with heart failure. home telemonitoring (HTM) to monitor patient's symptoms from a distance may be useful. This study attempts to assess changes in HTM vital signs in response to daily life activities (variations in medication, salt intake, exercise, and stress) and to establish which variations affect weight, blood pressure, and heart rate.

METHODS AND RESULTS

We assessed 76 patients with heart failure (mean age 76 ± 10.8 years, 75% male, mainly in NYHA class II/III and from ischaemic aetiology cause). Patients were given a calendar of interventions scheduling activities approximately twice a week before measuring their vital signs. Eating salty food or a large meal were the activities that had a significant impact on weight gain (+0.3 kg;  < 0.001 and  = 0.006, respectively). Exercise and skipping a dose of medication other than diuretics increased heart rate (+3 bpm,  = 0.001 and almost +2 bpm,  = 0.016, respectively).

CONCLUSIONS

Our HTM system was able to detect small changes in vital signs related to these activities. Further studies should assess if providing such a schedule of activities might be useful for patient education and could improve long-term adherence to recommended lifestyle changes.

摘要

目的

需要有替代策略来避免心力衰竭患者反复入院。远程家庭监测(HTM)以远距离监测患者症状可能会有所帮助。本研究试图评估HTM生命体征因日常生活活动(药物、盐摄入量、运动和压力的变化)而产生的变化,并确定哪些变化会影响体重、血压和心率。

方法和结果

我们评估了76例心力衰竭患者(平均年龄76±10.8岁,75%为男性,主要为纽约心脏协会II/III级,病因主要为缺血性)。在测量生命体征前,患者会收到一份干预日程表,安排大约每周两次的活动。食用咸味食物或大餐是对体重增加有显著影响的活动(分别增加0.3千克;<0.001和=0.006)。运动和漏服一剂非利尿剂药物会使心率增加(分别增加3次/分钟,=0.001和几乎增加2次/分钟,=0.016)。

结论

我们的HTM系统能够检测到与这些活动相关的生命体征的微小变化。进一步的研究应评估提供这样的活动日程表是否对患者教育有用,并能否提高对推荐的生活方式改变的长期依从性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c1d6/5747014/5e53891f3559/EHF2-4-66-g001.jpg

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