Bertagnin Enrico, Greco Antonio, Bottaro Giuseppe, Zappulla Paolo, Romanazzi Imma, Russo Maria Daniela, Lo Presti Marco, Valenti Noemi, Sollano Giuseppe, Calvi Valeria
Division of Cardiology, C.A.S.T., Azienda Ospedaliero-Universitaria Policlinico "G. Rodolico - San Marco", University of Catania, Italy.
Int J Cardiol Heart Vasc. 2021 Feb;32:100724. doi: 10.1016/j.ijcha.2021.100724. Epub 2021 Jan 28.
COVID-19 pandemic impacted on heart failure patients' lifestyle and quality of life, affecting both physical activity levels and state of health.
Demographic data and device records were extracted for patients with heart failure in the 16 weeks at the turn of lockdown during pandemic. To explore the variability across the lockdown period, a week-to-week analysis was performed. Patients were interviewed to investigate physical activity and psychological insights. The primary endpoint was the variation in physical activity at the turn of lockdown.
At our facility, 2225 patients implanted with a cardiac device were screened and data were collected for 211 patients fulfilling the inclusion criteria. Patients' physical activity significantly decreased in the lockdown period compared with the control period (active time per day 8.0% vs. 10.8%; relative reduction [RRR] 25.9%; p < 0.0001). A small decrease was noted for mean heart rate (70.1 vs. 71.7 beats per minute [bpm]; RRR 2.2%; p < 0.0001), while thoracic impedance slightly increased (82.2 vs. 82.7 ohm; RRR 0.6%; p = 0.001). Patients' physical activity decreased from week 7 to week 11 (10.9% vs. 6.9%; RRR 36.7%; P < 0.0001) with an increase between week 11 and week 16 (6.9% vs. 8.5%; RRR 18.8%; P < 0.0001). Patients' perceptions about physical activity showed a very low correlation with remote monitoring-assessed physical activity levels (r = 0.035, p = 0.039).
Telemedicine and remote monitoring can explore the impact of COVID-19 pandemic on vital signs and physical activity levels of heart failure patients, playing a crucial role in the prediction of heart failure worsening during circumstances discouraging outpatient visits.
新冠疫情对心力衰竭患者的生活方式和生活质量产生了影响，涉及身体活动水平和健康状况。
提取了疫情期间封锁交替时16周内心力衰竭患者的人口统计学数据和设备记录。为探究封锁期间的变化情况，进行了逐周分析。对患者进行访谈以调查身体活动和心理状况。主要终点是封锁交替时身体活动的变化。
在我们的机构，对2225例植入心脏设备的患者进行了筛查，收集了211例符合纳入标准患者的数据。与对照期相比，患者在封锁期的身体活动显著减少（每天活动时间8.0% 对10.8%；相对减少率[RRR] 25.9%；p < 0.0001）。平均心率略有下降（70.1对71.7次/分钟[bpm]；RRR 2.2%；p < 0.0001），而胸阻抗略有增加（82.2对82.7欧姆；RRR 0.6%；p = 0.001）。患者的身体活动从第7周降至第11周（10.9%对6.9%；RRR 36.7%；P < 0.0001），在第11周和第16周之间有所增加（6.9%对8.5%；RRR 18.8%；P < 0.0001）。患者对身体活动的认知与远程监测评估的身体活动水平相关性非常低（r = 0.035，p = 0.039）。
远程医疗和远程监测可探究新冠疫情对心力衰竭患者生命体征和身体活动水平的影响，在不利于门诊就诊的情况下对预测心力衰竭恶化起着关键作用。
