Arriola-Montenegro Jose, Mutirangura Pornthira, Akram Hassan, Tsangaris Adamantios, Koukousaki Despoina, Tschida Michael, Money Joel, Kosmopoulos Marinos, Harata Mikako, Hughes Andrew, Toth Andras, Alexy Tamas
Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
Department of Medicine, Division of Cardiology, University of Minnesota, Minneapolis, MN, 55127, USA.
Heart Fail Rev. 2024 Oct 22. doi: 10.1007/s10741-024-10441-7.
Heart failure remains one of the leading causes of mortality and hospitalizations in the US that not only impacts quality of life but also poses a significant public health burden. The majority of affected patients are admitted with signs and symptoms of congestion. Despite the initial enthusiasm, traditional remote monitoring strategies focusing primarily on weight gain failed to improve clinical outcomes. Implantable pulmonary artery pressure sensors provide earlier and actionable data, but most patients would favor forgoing an invasive procedure in favor of an alternative, non-invasive monitoring platform. Several devices utilizing different combinations of multiparameter monitoring to reliably detect congestion have recently been developed and are undergoing testing in the clinical setting. Combining these sensors with the power of artificial intelligence and machine learning has the potential to revolutionize remote patient monitoring and early congestion detection and to facilitate timely interventions by the care team to prevent hospitalization. This manuscript provides an objective review of novel, noninvasive, multiparameter remote monitoring platforms that may be tailored to individual heart failure phenotypes, aiming to improve quality of life and survival.
心力衰竭仍然是美国死亡率和住院率的主要原因之一,不仅影响生活质量,还带来巨大的公共卫生负担。大多数受影响的患者因充血的体征和症状而入院。尽管最初满怀热情,但主要关注体重增加的传统远程监测策略未能改善临床结局。植入式肺动脉压力传感器可提供更早且可采取行动的数据,但大多数患者更倾向于放弃侵入性手术,而选择替代性的非侵入性监测平台。最近已开发出几种利用多参数监测的不同组合来可靠检测充血的设备,并正在临床环境中进行测试。将这些传感器与人工智能和机器学习的力量相结合,有可能彻底改变远程患者监测和早期充血检测,并促进护理团队及时进行干预以防止住院。本文对可能针对个体心力衰竭表型量身定制的新型、非侵入性、多参数远程监测平台进行了客观综述,旨在提高生活质量和生存率。