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心力衰竭患者的真实多标记物监测:将活动能力的持续远程监测和患者报告结局作为未来心力衰竭试验的数字终点

Real-Life Multimarker Monitoring in Patients with Heart Failure: Continuous Remote Monitoring of Mobility and Patient-Reported Outcomes as Digital End Points in Future Heart-Failure Trials.

作者信息

Kramer Frank, Butler Javed, Shah Sanjiv J, Jung Christian, Nodari Savina, Rosenkranz Stephan, Senni Michele, Bamber Luke, Cichos Stephan, Dori Chrysanthi, Karakoyun Toeresin, Köhler Gabriele Jenny, Patel Kinjal, Piraino Paolo, Viethen Thomas, Chennuru Praneeth, Paydar Ayse, Sims Jason, Clark Richard, van Lummel Rob, Müller Alexandra, Gwaltney Chad, Smajlovic Salko, Düngen Hans-Dirk, Dinh Wilfried

机构信息

Bayer AG, Medical Devices & eHealth Clinical, Wuppertal, Germany.

Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA.

出版信息

Digit Biomark. 2020 Jun 30;4(2):45-59. doi: 10.1159/000507696. eCollection 2020 May-Aug.

Abstract

AIMS

Heart failure (HF) affects approximately 26 million people worldwide. With an aging global population, innovative approaches to HF evaluation and management are needed to cope with the worsening HF epidemic. The aim of the Real-Life Multimarker Monitoring in Patients with Heart Failure (REALIsM-HF) study (NCT03507439) is to evaluate a composite instrument comprising remote, real-time, activity-monitoring devices combined with daily electronic patient-reported outcome (ePRO) items in patients who have been hospitalized for HF and are undergoing standard HF assessment (e.g., 6-min walking distance [6MWD], blood biomarkers, Kansas City Cardiomyopathy Questionnaire [KCCQ], and echocardiography).

METHODS

REALIsM-HF is an ongoing, 12-week, observational study enrolling 80-100 patients aged ≥45 years with HF with preserved ejection fraction (HFpEF; EF ≥45%) or reduced EF (HFrEF; EF ≤35%). Statistical analyses will include examining the association between data from wearables (the AVIVO mobile patient management patch or VitalPatch biosensor, and the DynaPort MoveMonitor), daily ePROs, and conventional HF metrics (e.g., serum/plasma biomarkers, 6MWD, KCCQ, and echocardiographic parameters). The feasibility of and patient compliance with at-home devices will be documented, and the data captured for the purpose of establishing reference values in patients with HFpEF or HFrEF will be summarized.

CONCLUSIONS

The REALIsM-HF study is to evaluate the longitudinal daily activity profiles of patients with HF and correlate these with changes in serum/plasma biomarker profiles, symptoms, quality of life, and cardiac function and morphology to inform the use of wearable activity monitors for developing novel therapies and managing patients.

摘要

目的

心力衰竭(HF)在全球约影响2600万人。随着全球人口老龄化,需要创新的心力衰竭评估和管理方法来应对日益严重的心力衰竭流行问题。心力衰竭患者真实生活多标志物监测(REALIsM-HF)研究(NCT03507439)的目的是评估一种综合工具,该工具由远程、实时活动监测设备与每日电子患者报告结局(ePRO)项目组成,用于已因心力衰竭住院且正在接受标准心力衰竭评估(如6分钟步行距离[6MWD]、血液生物标志物、堪萨斯城心肌病问卷[KCCQ]和超声心动图)的患者。

方法

REALIsM-HF是一项正在进行的为期12周的观察性研究,招募80至100名年龄≥45岁、射血分数保留的心力衰竭(HFpEF;EF≥45%)或射血分数降低的心力衰竭(HFrEF;EF≤35%)患者。统计分析将包括检查可穿戴设备(AVIVO移动患者管理贴片或VitalPatch生物传感器以及DynaPort MoveMonitor)数据、每日ePRO与传统心力衰竭指标(如血清/血浆生物标志物、6MWD、KCCQ和超声心动图参数)之间的关联。将记录在家使用设备的可行性和患者依从性,并总结为建立HFpEF或HFrEF患者参考值而收集的数据。

结论

REALIsM-HF研究旨在评估心力衰竭患者的纵向日常活动概况,并将这些与血清/血浆生物标志物概况、症状、生活质量以及心脏功能和形态的变化相关联,以为使用可穿戴活动监测器开发新疗法和管理患者提供依据。

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