Daily ambulatory remote monitoring system for drug escalation in chronic heart failure with reduced ejection fraction : pilot phase of DAVID-HF study
© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology..
Aims: Underutilization of guideline-directed heart failure with reduced ejection fraction (HFrEF) medications contributes to poor outcomes.
Methods and results: A pilot study to evaluate the safety and efficacy of a home-based remote monitoring system for HFrEF management was performed. The system included wearable armband monitors paired with the smartphone application. An HFrEF medication titration algorithm was used to adjust medication daily. The primary endpoint was HFrEF medication utilization at 120 days. Twenty patients (60.5 ± 8.2 years, men: 85%) with HFrEF were recruited. All received angiotensin-converting enzyme inhibitor (ACEI)/angiotensin receptor blocker (ARB)/angiotensin receptor-neprilysin inhibitor (ARNI) at recruitment; 45% received ≥50% maximal targeted dose (MTD) with % MTD of 44.4 ± 31.7%. At baseline, 90 and 70% received beta-adrenergic blocker and mineralocorticoid receptor antagonist (MRA), 35% received ≥50% MTD beta-adrenergic blocker with % MTD of 34.1 ± 29.6%, and 25% received ≥50% MTD MRA with % MTD of 25.0 ± 19.9%. At 120 days, 70% received ≥50% MTD ACEI/ARB/ARNI (P = 0.110) with % MTD increased to 64.4 ± 33.5% (P = 0.060). The proportion receiving ≥50% MTD ARNI increased from 15 to 55% (P = 0.089) with % MTD ARNI increased from 20.6 ± 30.9 to 53.1 ± 39.5% (P = 0.006*). More patients received ≥50% MTD MRA (65 vs. 25%, P = 0.011*) with % MTD MRA increased from 25.0 ± 19.9 to 46.2 ± 28.8% (P = 0.009*). Ninety-five per cent of patients had reduced NT-proBNP with the percentage reduction of 26.7 ± 19.7%.
Conclusion: Heart failure with reduced ejection fraction medication escalation with remote monitoring appeared feasible.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2022 |
|---|---|
| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:3 |
|---|---|
| Enthalten in: |
European heart journal. Digital health - 3(2022), 2 vom: 20. Juni, Seite 284-295 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Wong, Chun Ka [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
|---|
| Anmerkungen: |
Date Revised 02.02.2023 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
|---|
| doi: |
10.1093/ehjdh/ztac024 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM352234334 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM352234334 | ||
| 003 | DE-627 | ||
| 005 | 20231226053242.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2022 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1093/ehjdh/ztac024 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1174.xml |
| 035 | |a (DE-627)NLM352234334 | ||
| 035 | |a (NLM)36713022 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Wong, Chun Ka |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Daily ambulatory remote monitoring system for drug escalation in chronic heart failure with reduced ejection fraction |b pilot phase of DAVID-HF study |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 02.02.2023 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology. | ||
| 520 | |a Aims: Underutilization of guideline-directed heart failure with reduced ejection fraction (HFrEF) medications contributes to poor outcomes | ||
| 520 | |a Methods and results: A pilot study to evaluate the safety and efficacy of a home-based remote monitoring system for HFrEF management was performed. The system included wearable armband monitors paired with the smartphone application. An HFrEF medication titration algorithm was used to adjust medication daily. The primary endpoint was HFrEF medication utilization at 120 days. Twenty patients (60.5 ± 8.2 years, men: 85%) with HFrEF were recruited. All received angiotensin-converting enzyme inhibitor (ACEI)/angiotensin receptor blocker (ARB)/angiotensin receptor-neprilysin inhibitor (ARNI) at recruitment; 45% received ≥50% maximal targeted dose (MTD) with % MTD of 44.4 ± 31.7%. At baseline, 90 and 70% received beta-adrenergic blocker and mineralocorticoid receptor antagonist (MRA), 35% received ≥50% MTD beta-adrenergic blocker with % MTD of 34.1 ± 29.6%, and 25% received ≥50% MTD MRA with % MTD of 25.0 ± 19.9%. At 120 days, 70% received ≥50% MTD ACEI/ARB/ARNI (P = 0.110) with % MTD increased to 64.4 ± 33.5% (P = 0.060). The proportion receiving ≥50% MTD ARNI increased from 15 to 55% (P = 0.089) with % MTD ARNI increased from 20.6 ± 30.9 to 53.1 ± 39.5% (P = 0.006*). More patients received ≥50% MTD MRA (65 vs. 25%, P = 0.011*) with % MTD MRA increased from 25.0 ± 19.9 to 46.2 ± 28.8% (P = 0.009*). Ninety-five per cent of patients had reduced NT-proBNP with the percentage reduction of 26.7 ± 19.7% | ||
| 520 | |a Conclusion: Heart failure with reduced ejection fraction medication escalation with remote monitoring appeared feasible | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Drug escalation | |
| 650 | 4 | |a Heart failure | |
| 650 | 4 | |a Telemonitoring | |
| 700 | 1 | |a Un, Ka Chun |e verfasserin |4 aut | |
| 700 | 1 | |a Zhou, Mi |e verfasserin |4 aut | |
| 700 | 1 | |a Cheng, Yangyang |e verfasserin |4 aut | |
| 700 | 1 | |a Lau, Yuk Ming |e verfasserin |4 aut | |
| 700 | 1 | |a Shea, Puigi Catherine |e verfasserin |4 aut | |
| 700 | 1 | |a Lui, Hin Wai |e verfasserin |4 aut | |
| 700 | 1 | |a Zuo, Ming Liang |e verfasserin |4 aut | |
| 700 | 1 | |a Yin, Li Xue |e verfasserin |4 aut | |
| 700 | 1 | |a Chan, Esther W |e verfasserin |4 aut | |
| 700 | 1 | |a Wong, Ian C K |e verfasserin |4 aut | |
| 700 | 1 | |a Sin, Simon Wai Ching |e verfasserin |4 aut | |
| 700 | 1 | |a Yeung, Pauline Pui Ning |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Hao |e verfasserin |4 aut | |
| 700 | 1 | |a Wibowo, Sandi |e verfasserin |4 aut | |
| 700 | 1 | |a Wei, Tong Li Nikki |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Sze Ming |e verfasserin |4 aut | |
| 700 | 1 | |a Chow, Augustine |e verfasserin |4 aut | |
| 700 | 1 | |a Tong, Raymond Cheuk Fung |e verfasserin |4 aut | |
| 700 | 1 | |a Hai, Jojo |e verfasserin |4 aut | |
| 700 | 1 | |a Tam, Frankie Chor Cheung |e verfasserin |4 aut | |
| 700 | 1 | |a Siu, Chung Wah |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t European heart journal. Digital health |d 2020 |g 3(2022), 2 vom: 20. Juni, Seite 284-295 |w (DE-627)NLM325972273 |x 2634-3916 |7 nnns |
| 773 | 1 | 8 | |g volume:3 |g year:2022 |g number:2 |g day:20 |g month:06 |g pages:284-295 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1093/ehjdh/ztac024 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 3 |j 2022 |e 2 |b 20 |c 06 |h 284-295 | ||