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对心力衰竭患者远程监测的新兴技术的现状和未来展望。

A current and future outlook on upcoming technologies in remote monitoring of patients with heart failure.

机构信息

Division of Cardiology, Angiology and Intensive Medical Care, Department of Internal Medicine I, University Hospital Magdeburg, Otto von Guericke-University, Magdeburg, Germany.

Division of Cardiology, Duke University Medical Center, Durham, NC, USA.

出版信息

Eur J Heart Fail. 2021 Jan;23(1):175-185. doi: 10.1002/ejhf.2033. Epub 2020 Nov 18.

Abstract

Heart failure is a major health and economic challenge in both developing and developed countries. Despite advances in pharmacological and device therapies for patients with a reduced left ventricular ejection fraction (LVEF) and heart failure, their quality of life and exercise capacity are often persistently impaired, morbidity and mortality remain high and the health economic and societal costs are considerable. For patients with heart failure and preserved LVEF, diuretic management has an essential role for controlling congestion and symptoms, even if no intervention has convincingly shown to reduce morbidity or mortality. Remote monitoring might improve care delivery and clinical outcomes for patients regardless of LVEF. A great variety of innovative remote monitoring technologies and algorithms are being introduced, including patient self-managed testing, wearable devices, technologies either integrated into established clinically indicated therapeutic devices, such as pacemakers and defibrillators, or as stand-alone are in development providing the promise of further improvements in service delivery and clinical outcomes. In this article, we will discuss unmet needs in the management of patients with heart failure, how remote monitoring might contribute to future solutions, and provide an overview of current and novel remote monitoring technologies.

摘要

心力衰竭是发展中国家和发达国家面临的重大健康和经济挑战。尽管在左心室射血分数(LVEF)降低和心力衰竭患者的药物和设备治疗方面取得了进展,但他们的生活质量和运动能力常常持续受损,发病率和死亡率仍然很高,健康经济和社会成本相当可观。对于射血分数保留的心力衰竭患者,利尿剂管理对于控制充血和症状具有重要作用,即使没有干预措施能够令人信服地降低发病率或死亡率。远程监测可以改善心力衰竭患者的护理提供和临床结果,无论 LVEF 如何。正在引入各种创新的远程监测技术和算法,包括患者自我管理测试、可穿戴设备、集成到既定临床指示治疗设备(如起搏器和除颤器)中的技术,或者作为独立设备正在开发中,有望进一步改善服务提供和临床结果。在本文中,我们将讨论心力衰竭患者管理中的未满足需求,以及远程监测如何为未来的解决方案做出贡献,并概述当前和新型远程监测技术。

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