JMIR Cardio最新文献

{"title":"The Effect of Inhaled Beta-2 Agonists on Heart Rate in Patients With Asthma: Sensor-Based Observational Study.","authors":"Rishi Jayant Khusial, Jacob K Sont, Omar S Usmani, Matteo Bonini, Kian Fan Chung, Stephen James Fowler, Persijn J Honkoop","doi":"10.2196/56848","DOIUrl":"10.2196/56848","url":null,"abstract":"<p><strong>Background: </strong>Beta-2 agonists play an important role in the management of asthma. Inhaled long-acting beta-2 agonists (LABAs) and short-acting beta-2 agonists (SABAs) cause bronchodilation by stimulating adrenoceptors. These receptors are also present in cardiac cells and, as a side effect, could also be stimulated by inhaled beta-2 agonists.</p><p><strong>Objective: </strong>This study aims to assess the effect of beta-2 agonists on heart rate (HR).</p><p><strong>Methods: </strong>The data were retrieved from an observational study, the myAirCoach Quantification Campaign. Beta-2 agonist use was registered by self-reported monthly questionnaires and by smart inhalers. HR was monitored continuously with the Fitbit Charge HR tracker (Fitbit Inc). Patients (aged 18 years and older) were recruited if they had uncontrolled asthma and used inhalation medication. Our primary outcome was the difference in HR between LABA and non-LABA users. Secondary outcomes were the difference in HR on days SABAs were used compared to days SABAs were not used and an assessment of the timing of inhaler use during the day.</p><p><strong>Results: </strong>Patients using LABA did not have a clinically relevant higher HR (average 0.8 beats per minute difference) during the day. Around the moment of SABA inhalation itself, the HR does increase steeply, and it takes 138 minutes before it returns to the normal range.</p><p><strong>Conclusions: </strong>This study indicates that LABAs do not have a clinically relevant effect on HR. SABAs are instead associated with a short-term HR increase.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT02774772; https://clinicaltrials.gov/study/NCT02774772.</p>","PeriodicalId":14706,"journal":{"name":"JMIR Cardio","volume":"8 ","pages":"e56848"},"PeriodicalIF":0.0,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11669870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Cloud-Based Machine Learning Platform to Predict Clinical Outcomes at Home for Patients With Cardiovascular Conditions Discharged From Hospital: Clinical Trial.","authors":"Phillip C Yang, Alokkumar Jha, William Xu, Zitao Song, Patrick Jamp, Jeffrey J Teuteberg","doi":"10.2196/68825","DOIUrl":"10.2196/68825","url":null,"abstract":"<p><p>[This corrects the article DOI: .].</p>","PeriodicalId":14706,"journal":{"name":"JMIR Cardio","volume":"8 ","pages":"e68825"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Video-Based Telemedicine Visits and Medication Adherence Among Patients With Heart Failure: Retrospective Cross-Sectional Study.","authors":"Yaguang Zheng, Samrachana Adhikari, Xiyue Li, Yunan Zhao, Amrita Mukhopadhyay, Carine E Hamo, Tyrel Stokes, Saul Blecker","doi":"10.2196/56763","DOIUrl":"10.2196/56763","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Despite the exponential growth in telemedicine visits in clinical practice due to the COVID-19 pandemic, it remains unknown if telemedicine visits achieved similar adherence to prescribed medications as in-person office visits for patients with heart failure.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Our study examined the association between telemedicine visits (vs in-person visits) and medication adherence in patients with heart failure.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This was a retrospective cross-sectional study of adult patients with a diagnosis of heart failure or an ejection fraction of ≤40% using data between April 1 and October 1, 2020. This period was used because New York University approved telemedicine visits for both established and new patients by April 1, 2020. The time zero window was between April 1 and October 1, 2020, then each identified patient was monitored for up to 180 days. Medication adherence was measured by the mean proportion of days covered (PDC) within 180 days, and categorized as adherent if the PDC was ≥0.8. Patients were included in the telemedicine exposure group or in-person group if all encounters were video visits or in-person office visits, respectively. Poisson regression and logistic regression models were used for the analyses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 9521 individuals were included in this analysis (telemedicine visits only: n=830 in-person office visits only: n=8691). Overall, the mean age was 76.7 (SD 12.4) years. Most of the patients were White (n=6996, 73.5%), followed by Black (n=1060, 11.1%) and Asian (n=290, 3%). Over half of the patients were male (n=5383, 56.5%) and over half were married or living with partners (n=4914, 51.6%). Most patients' health insurance was covered by Medicare (n=7163, 75.2%), followed by commercial insurance (n=1687, 17.7%) and Medicaid (n=639, 6.7%). Overall, the average PDC was 0.81 (SD 0.286) and 71.3% (6793/9521) of patients had a PDC≥0.8. There was no significant difference in mean PDC between the telemedicine and in-person office groups (mean 0.794, SD 0.294 vs mean 0.812, SD 0.285) with a rate ratio of 0.99 (95% CI 0.96-1.02; P=.09). Similarly, there was no significant difference in adherence rates between the telemedicine and in-person office groups (573/830, 69% vs 6220/8691, 71.6%), with an odds ratio of 0.94 (95% CI 0.81-1.11; P=.12). The conclusion remained the same after adjusting for covariates (eg, age, sex, race, marriage, language, and insurance).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;We found similar rates of medication adherence among patients with heart failure who were being seen via telemedicine or in-person visits. Our findings are important for clinical practice because we provide real-world evidence that telemedicine can be an approach for outpatient visits for patients with heart failure. As telemedicine is more convenient and avoids transportation issues, it may be an alternative way to maintain the sam","PeriodicalId":14706,"journal":{"name":"JMIR Cardio","volume":"8 ","pages":"e56763"},"PeriodicalIF":0.0,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11637490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of an mHealth App (Kencom) on Patients With Untreated Hypertension Initiating Antihypertensive Medications: Real-World Cohort Study.","authors":"Koichiro Matsumura, Atsushi Nakagomi, Eijiro Yagi, Nobuhiro Yamada, Yohei Funauchi, Kazuyoshi Kakehi, Ayano Yoshida, Takayuki Kawamura, Masafumi Ueno, Gaku Nakazawa, Takahiro Tabuchi","doi":"10.2196/52266","DOIUrl":"10.2196/52266","url":null,"abstract":"<p><strong>Background: </strong>To prevent the further development of cardiovascular diseases, it is a growing global priority to detect untreated hypertension in patients and ensure adequate blood pressure control via drug therapy. However, few effective tools that facilitate the initiation of antihypertensive medications among such patients have been identified.</p><p><strong>Objective: </strong>We aimed to determine whether a mobile health (mHealth) app facilitates the initiation of antihypertensive medications among patients with untreated hypertension.</p><p><strong>Methods: </strong>We analyzed a large longitudinal integrated database mainly comprised of data from middle-aged, employed people and their families. The database contained data from health checkups, health insurance claims, and the mHealth app kencom. kencom is used to manage daily life logs (eg, weight, number of steps) and to provide health information tailored to customers. Patients with untreated hypertension were identified using the baseline health checkup data, and follow-up health checkups were conducted to identify the rate of initiation of antihypertensive medications between mHealth app users and nonusers. Antihypertensive medication status was confirmed via a questionnaire administered during the medical checkup as well as a review of the health insurance claims database. We conducted a modified Poisson regression analysis, weighted by inverse probability of treatment weighting, to examine the effect of mHealth app usage on the initiation of antihypertensive medications. Additionally, data from four lifestyle questionnaires from the baseline and follow-up health checkups were collected to evaluate lifestyle modifications that could be attributed to the mHealth app.</p><p><strong>Results: </strong>Data were collected from 50,803 eligible patients (mean age 49, SD 9 years; men n=39,412, 77.6%; women n=11,391, 22.4%) with a median follow-up period of 3.0 (IQR 2.3-3.1) years. The rate of initiation of antihypertensive medications was significantly higher in the mHealth app user group than in the nonuser group: 23.4% (3482/14,879) versus 18.5% (6646/35,924; P<.001), respectively. The risk ratio of mHealth app usage for initiated antihypertensive medications was 1.28 (95% CI 1.23-1.33). Among those who did not intend to improve their lifestyle habits such as exercise and diet at baseline, the rate of lifestyle improvement at follow-up was compared between mHealth app users and nonusers, using data from the questionnaires; mHealth app users demonstrated a significantly higher rate of lifestyle changes than nonusers.</p><p><strong>Conclusions: </strong>For patients with untreated hypertension, the use of the mHealth app kencom, which was not dedicated to hypertension treatment, was associated with a higher initiation of antihypertensive medications.</p>","PeriodicalId":14706,"journal":{"name":"JMIR Cardio","volume":"8 ","pages":"e52266"},"PeriodicalIF":0.0,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11612529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Auscultation Quality Using Contemporary Digital Stethoscopes.","authors":"Norah Saraya, Jonathon McBride, Karandeep Singh, Omar Sohail, Porag Jeet Das","doi":"10.2196/54746","DOIUrl":"10.2196/54746","url":null,"abstract":"","PeriodicalId":14706,"journal":{"name":"JMIR Cardio","volume":"8 ","pages":"e54746"},"PeriodicalIF":0.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11584529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Development of Heart Failure Electronic-Message Driven Tips to Support Self-Management: Co-Design Case Study.","authors":"Caleb Ferguson, Scott William, Sabine M Allida, Jordan Fulcher, Alicia J Jenkins, Jo-Dee Lattimore, L-J Loch, Anthony Keech","doi":"10.2196/57328","DOIUrl":"10.2196/57328","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) is a complex syndrome associated with high morbidity and mortality and increased health care use. Patient education is key to improving health outcomes, achieved by promoting self-management to optimize medical management. Newer digital tools like SMS text messaging and smartphone apps provide novel patient education approaches.</p><p><strong>Objective: </strong>This study aimed to partner with clinicians and people with lived experience of HF to identify the priority educational topic areas to inform the development and delivery of a bank of electronic-message driven tips (e-TIPS) to support HF self-management.</p><p><strong>Methods: </strong>We conducted 3 focus groups with cardiovascular clinicians, people with lived experience of HF, and their caregivers, which consisted of 2 stages: stage 1 (an exploratory qualitative study to identify the unmet educational needs of people living with HF; previously reported) and stage 2 (a co-design feedback session to identify educational topic areas and inform the delivery of e-TIPS). This paper reports the findings of the co-design feedback session.</p><p><strong>Results: </strong>We identified 5 key considerations in delivering e-TIPS and 5 relevant HF educational topics for their content. Key considerations in e-TIP delivery included (1) timing of the e-TIPS; (2) clear and concise e-TIPS; (3) embedding a feedback mechanism; (4) distinguishing actionable and nonactionable e-TIPS; and (5) frequency of e-TIP delivery. Relevant educational topic areas included the following: (1) cardiovascular risk reduction, (2) self-management, (3) food and nutrition, (4) sleep hygiene, and (5) mental health.</p><p><strong>Conclusions: </strong>The findings from this co-design case study have provided a foundation for developing a bank of e-TIPS. These will now be evaluated for usability in the BANDAIDS e-TIPS, a single-group, quasi-experimental study of a 24-week e-TIP program (personalized educational messages) delivered via SMS text messaging (ACTRN12623000644662).</p>","PeriodicalId":14706,"journal":{"name":"JMIR Cardio","volume":"8 ","pages":"e57328"},"PeriodicalIF":0.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying the Severity of Heart Valve Stenosis and Regurgitation Among a Diverse Population Within an Integrated Health Care System: Natural Language Processing Approach.","authors":"Fagen Xie, Ming-Sum Lee, Salam Allahwerdy, Darios Getahun, Benjamin Wessler, Wansu Chen","doi":"10.2196/60503","DOIUrl":"10.2196/60503","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Valvular heart disease (VHD) is a leading cause of cardiovascular morbidity and mortality that poses a substantial health care and economic burden on health care systems. Administrative diagnostic codes for ascertaining VHD diagnosis are incomplete.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to develop a natural language processing (NLP) algorithm to identify patients with aortic, mitral, tricuspid, and pulmonic valve stenosis and regurgitation from transthoracic echocardiography (TTE) reports within a large integrated health care system.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We used reports from echocardiograms performed in the Kaiser Permanente Southern California (KPSC) health care system between January 1, 2011, and December 31, 2022. Related terms/phrases of aortic, mitral, tricuspid, and pulmonic stenosis and regurgitation and their severities were compiled from the literature and enriched with input from clinicians. An NLP algorithm was iteratively developed and fine-trained via multiple rounds of chart review, followed by adjudication. The developed algorithm was applied to 200 annotated echocardiography reports to assess its performance and then the study echocardiography reports.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 1,225,270 TTE reports were extracted from KPSC electronic health records during the study period. In these reports, valve lesions identified included 111,300 (9.08%) aortic stenosis, 20,246 (1.65%) mitral stenosis, 397 (0.03%) tricuspid stenosis, 2585 (0.21%) pulmonic stenosis, 345,115 (28.17%) aortic regurgitation, 802,103 (65.46%) mitral regurgitation, 903,965 (73.78%) tricuspid regurgitation, and 286,903 (23.42%) pulmonic regurgitation. Among the valves, 50,507 (4.12%), 22,656 (1.85%), 1685 (0.14%), and 1767 (0.14%) were identified as prosthetic aortic valves, mitral valves, tricuspid valves, and pulmonic valves, respectively. Mild and moderate were the most common severity levels of heart valve stenosis, while trace and mild were the most common severity levels of regurgitation. Males had a higher frequency of aortic stenosis and all 4 valvular regurgitations, while females had more mitral, tricuspid, and pulmonic stenosis. Non-Hispanic Whites had the highest frequency of all 4 valvular stenosis and regurgitations. The distribution of valvular stenosis and regurgitation severity was similar across race/ethnicity groups. Frequencies of aortic stenosis, mitral stenosis, and regurgitation of all 4 heart valves increased with age. In TTE reports with stenosis detected, younger patients were more likely to have mild aortic stenosis, while older patients were more likely to have severe aortic stenosis. However, mitral stenosis was opposite (milder in older patients and more severe in younger patients). In TTE reports with regurgitation detected, younger patients had a higher frequency of severe/very severe aortic regurgitation. In comparison, older patients had higher frequencies of mild","PeriodicalId":14706,"journal":{"name":"JMIR Cardio","volume":"8 ","pages":"e60503"},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11474122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A co-design case study of the development of heart failure e-TIPS to support self-management.","authors":"Caleb Ferguson, Scott William, Sabine M Allida, Jordan Fulcher, Alicia J Jenkins, Jo-Dee Lattimore, L-J Loch, Anthony Keech","doi":"10.2196/57328","DOIUrl":"10.2196/57328","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) is a complex syndrome associated with high morbidity and mortality and increased healthcare utilisation. Patient education is key to improving health outcomes, achieved by promoting self-management to optimise medical management. Newer digital tools like text messaging and smartphone applications provide novel patient education approaches.</p><p><strong>Objective: </strong>To partner with clinicians and people with lived experience of HF to identify the priority educational topic areas to inform the development and delivery of a bank of electronic-message driven tips ('e-TIPS') to support HF self-management.</p><p><strong>Methods: </strong>We conducted three focus groups with cardiovascular clinicians, people with lived experience of HF and their caregivers, which consisted of two stages: Stage 1 - an exploratory qualitative study to identify the unmet educational needs of people living with HF (previously reported) and Stage 2 - a co-design feedback session to identify educational topic areas and inform the delivery of e-TIPS. This paper reports the findings of the co-design feedback session.</p><p><strong>Results: </strong>We identified five key considerations in delivering e-TIPS and five relevant HF educational topics for their content. Key considerations in e-TIP delivery included: (i) Timing of the e-TIPS; (ii) Clear and concise e-TIPS; (iii) Embedding a feedback mechanism; (iv) Distinguishing actionable and non-actionable e-TIPS; and (v) Frequency of e-TIP delivery. Relevant educational topic areas included: (i) cardiovascular risk reduction; (ii) Self-management; (iii) Food and nutrition; (iv) Sleep hygiene; and (v) Mental health.</p><p><strong>Conclusions: </strong>The findings from this co-design case study have provided a foundation for developing a bank of e-TIPS. These will now be evaluated for usability in the BANDAIDS e-TIPS, a single group, quasi-experimental study of a 24-week e-TIP program (personalised educational messages) delivered via Short Message Service (ACTRN12623000644662).</p><p><strong>Clinicaltrial: </strong></p>","PeriodicalId":14706,"journal":{"name":"JMIR Cardio","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smart Device Ownership and Use of Social Media, Wearable Trackers, and Health Apps Among Black Women With Hypertension in the United States: National Survey Study.","authors":"Jolaade Kalinowski, Sandesh Bhusal, Sherry L Pagoto, Robert Newton, Molly E Waring","doi":"10.2196/59243","DOIUrl":"10.2196/59243","url":null,"abstract":"<p><p>The majority of Black women with hypertension in the United States have smartphones or tablets and use social media, and many use wearable activity trackers and health or wellness apps, digital tools that can be used to support lifestyle changes and medication adherence.</p>","PeriodicalId":14706,"journal":{"name":"JMIR Cardio","volume":"8 ","pages":"e59243"},"PeriodicalIF":0.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11420575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of a New Telemedicine System for Early Detection of Cardiac Instability in Patients With Chronic Heart Failure: Real-Life Out-of-Hospital Study.","authors":"Jean Marie Urien, Emmanuelle Berthelot, Pierre Raphael, Thomas Moine, Marie Emilie Lopes, Patrick Assayag, Patrick Jourdain","doi":"10.2196/52648","DOIUrl":"10.2196/52648","url":null,"abstract":"<p><strong>Background: </strong>For a decade, despite results from many studies, telemedicine systems have suffered from a lack of recommendations for chronic heart failure (CHF) care because of variable study results. Another limitation is the hospital-based architecture of most telemedicine systems. Some systems use an algorithm based on daily weight, transcutaneous oxygen measurement, and heart rate to detect and treat acute heart failure (AHF) in patients with CHF as early on as possible.</p><p><strong>Objective: </strong>The aim of this study is to determine the efficacy of a telemonitoring system in detecting clinical destabilization in real-life settings (out-of-hospital management) without generating too many false positive alerts.</p><p><strong>Methods: </strong>All patients self-monitoring at home using the system after a congestive AHF event treated at a cardiology clinic in France between March 2020 and March 2021 with at least 75% compliance on daily measurements were included retrospectively. New-onset AHF was defined by the presence of at least 1 of the following criteria: transcutaneous oxygen saturation loss, defined as a transcutaneous oxygen measurement under 90%; rise of cardiac frequency above 110 beats per minute; weight gain of at least 2 kg; and symptoms of congestive AHF, described over the phone. An AHF alert was generated when the criteria reached our definition of new-onset acute congestive heart failure (HF).</p><p><strong>Results: </strong>A total of 111 consecutive patients (n=70 men) with a median age of 76.60 (IQR 69.5-83.4) years receiving the telemonitoring system were included. Thirty-nine patients (35.1%) reached the HF warning level, and 28 patients (25%) had confirmed HF destabilization during follow-up. No patient had AHF without being detected by the telemonitoring system. Among incorrect AHF alerts (n=11), 5 patients (45%) had taken inaccurate measurements, 3 patients (27%) had supraventricular arrhythmia, 1 patient (9%) had a pulmonary bacterial infection, and 1 patient (9%) contracted COVID-19. A weight gain of at least 2 kg within 4 days was significantly associated with a correct AHF alert (P=.004), and a heart rate of more than 110 beats per minute was more significantly associated with an incorrect AHF alert (P=.007).</p><p><strong>Conclusions: </strong>This single-center study highlighted the efficacy of the telemedicine system in detecting and quickly treating cardiac instability complicating the course of CHF by detecting new-onset AHF as well as supraventricular arrhythmia, thus helping cardiologists provide better follow-up to ambulatory patients.</p>","PeriodicalId":14706,"journal":{"name":"JMIR Cardio","volume":"8 ","pages":"e52648"},"PeriodicalIF":0.0,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11350300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141971164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}