Imamura Teruhiko
Second Department of Internal Medicine, University of Toyama, Toyama 930-0194, Japan.
J Clin Med. 2025 Sep 1;14(17):6182. doi: 10.3390/jcm14176182.
Heart failure (HF) remains a global health challenge with high rates of hospitalization and mortality, particularly among the elderly. Many episodes of worsening HF occur before symptoms arise, underscoring the need for sensitive monitoring tools. Respiratory Stability Time (RST) is a novel index that quantifies the duration of stable respiration during sleep, reflecting pulmonary congestion and circulatory status. RST can be measured continuously and non-invasively using a contactless under-mattress sensor. Observational cohort studies show that low RST predicts poor prognosis, while its improvement parallels recovery from decompensation. Importantly, recent prospective multicenter observations involving 100 patients demonstrated that sustained RST decline often precedes HF readmission, probably enabling early intervention. A multicenter trial (ITMETHOD-HF III), involving 80 patients, is currently testing whether RST-guided therapy can reduce HF readmissions. RST might substantially enhance current HF management by enabling us to provide proactive therapeutic intervention, though further validation is warranted.
心力衰竭（HF）仍然是一项全球性的健康挑战，住院率和死亡率居高不下，在老年人中尤为如此。许多心力衰竭恶化事件在症状出现之前就已发生，这凸显了对敏感监测工具的需求。呼吸稳定时间（RST）是一项新指标，用于量化睡眠期间稳定呼吸的持续时间，反映肺充血和循环状态。使用非接触式床垫下传感器可以连续且无创地测量RST。观察性队列研究表明，低RST预示着预后不良，而其改善与失代偿的恢复情况平行。重要的是，最近涉及100名患者的前瞻性多中心观察表明，RST持续下降往往先于心力衰竭再次入院，这可能有助于早期干预。一项涉及80名患者的多中心试验（ITMETHOD-HF III）目前正在测试RST指导的治疗是否可以减少心力衰竭再次入院。RST可能会通过使我们能够提供积极的治疗干预措施，从而大幅改善当前的心力衰竭管理，不过仍需进一步验证。
