Early Detection of Worsening Heart Failure in Patients at Home Using a New Telemonitoring System of Respiratory Stability

概要

〔目的(Purpose)〕
　Early detection of worsening heart failure (HF) with a telemonitoring system crucially depends on monitoring parameters. The present study aimed to examine whether a serial follow-up of all-night respiratory stability time (RST) built in the telemonitoring system could faithfully reflect ongoing deterioration in HF patients at home and detect early signs of worsening HF in a multi center, prospective study.

〔方法ならびに成績(Methods/Results)〕
　Seventeen subjects with New York Heart Association class II or III were followed up for a mean of 9 months using a newly developed telemonitoring system equipped with non-attached sensor technologies and automatic RST analysis. Signals from the home sensor were transferred to a cloud server, where all-night RSTs were calculated every morning and traced by the monitoring center. During the follow­ up, nine episodes of admission due to worsening HF and one episode of sudden death were preceded by progressive declines of RST. The receiver operating characteristic curve demonstrated that the progressive or sustained reduction of RST below 20 sec during 28 days before hospital admission achieved the highest sensitivity of 90.0% and specificity of 81.7% to subsequent hospitalization with the area under the curve of 0.85.

[総括(Conclusion)]
　RST could serve as a sensitive and specific indicator of worsening HF and allow to detect an early sign of clinical deterioration in telemedical management of HF.