scholarly journals In Search of Clinical Impact: Advanced Monitoring Technologies in Daily Heart Failure Care

2021 ◽  
Vol 10 (20) ◽  
pp. 4692
Author(s):  
Dean Nachman ◽  
Eldad Rahamim ◽  
Yotam Kolben ◽  
Bethlehem Mengesha ◽  
Gabby Elbaz-Greener ◽  
...  
Keyword(s):  
Heart Failure ◽  
Microelectromechanical Systems ◽  
Unmet Need ◽  
Signs And Symptoms ◽  
Therapeutic Interventions ◽  
Novel Technologies ◽  
Lung Fluid ◽  
Heart Failure Care ◽  
Cardiac Filling ◽  
Monitoring Technologies

Despite significant advances in the management of heart failure (HF), further improvement in the outcome of this chronic and progressive disease is still considered a major unmet need. Recurrent hospitalizations due to decompensated HF frequently occur, resulting in increased morbidity and mortality rates. Past attempts at early detection of clinical deterioration were mainly based on monitoring of signs and symptoms of HF exacerbation, which have mostly given disappointing results. Extensive research of the pathophysiology of HF decompensation has indicated that hemodynamic alterations start days prior to clinical manifestation. Novel technologies aim to monitor these minute hemodynamic changes, allowing time for therapeutic interventions to prevent hemodynamic derangement and HF exacerbation. The latest noticeable advancements include assessment of lung fluid volume, wearable devices with integrated sensors, and microelectromechanical systems-based implantable devices for continuous measurement of cardiac filling pressures. This manuscript will review the rationale for monitoring HF patients and discuss previous and ongoing attempts to develop clinically meaningful monitoring devices to improve daily HF health care, with particular emphasis on the recent advances and clinical trials relevant to this evolving field.

scholarly journals Enhancing Safety During a Pandemic Using Virtual Care Remote Monitoring Technologies and UML Modeling

2021 ◽  
Author(s):  
Elizabeth M. Borycki ◽  
Andre W. Kushniruk ◽  
Ryan Kletke ◽  
Vivian Vimarlund ◽  
Yalini Senathirajah ◽  
...  
Keyword(s):  
Remote Monitoring ◽  
Virus Disease ◽  
Grey Literature ◽  
Object Oriented ◽  
Signs And Symptoms ◽  
Use Cases ◽  
Virtual Care ◽  
The Future ◽  
Government Websites ◽  
Monitoring Technologies

Objectives: This paper describes a methodology for gathering requirements and early design of remote monitoring technology (RMT) for enhancing patient safety during pandemics using virtual care technologies. As pandemics such as COrona VIrus Disease (COVID-19) progress there is an increasing need for effective virtual care and RMT to support patient care while they are at home. Methods: The authors describe their work in conducting literature reviews by searching PubMed.gov and the grey literature for articles, and government websites with guidelines describing the signs and symptoms of COVID-19, as well as the progression of the disease. The reviews focused on identifying gaps where RMT could be applied in novel ways and formed the basis for the subsequent modelling of use cases for applying RMT described in this paper. Results: The work was conducted in the context of a new Home of the Future laboratory which has been set up at the University of Victoria. The literature review led to the development of a number of object-oriented models for deploying RMT. This modeling is being used for a number of purposes, including for education of students in health infomatics as well as testing of new use cases for RMT with industrial collaborators and projects within the smart home of the future laboratory. Conclusions: Object-oriented modeling, based on analysis of gaps in the literature, was found to be a useful approach for describing, communicating and teaching about potential new uses of RMT.

scholarly journals Pulmonary Congestion Assessment in Heart Failure: Traditional and New Tools

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1306
Author(s):  
Filippo Pirrotta ◽  
Benedetto Mazza ◽  
Luigi Gennari ◽  
Alberto Palazzuoli
Keyword(s):  
Heart Failure ◽  
Adverse Outcome ◽  
Volume Overload ◽  
Pulmonary Congestion ◽  
X Ray ◽  
Persistent Symptoms ◽  
Biochemical Evaluation ◽  
Cardiac Filling ◽  
Symptoms And Signs

Congestion related to cardiac pressure and/or volume overload plays a central role in the pathophysiology, presentation, and prognosis of heart failure (HF). Most HF exacerbations are related to a progressive rise in cardiac filling pressures that precipitate pulmonary congestion and symptomatic decompensation. Furthermore, persistent symptoms and signs of congestion at discharge or among outpatients are strong predictors of an adverse outcome. Pulmonary congestion is also one of the most important diagnostic and therapeutic targets in chronic heart failure. The aim of this review is to analyze the importance of clinical, instrumental, and biochemical evaluation of congestion in HF by describing old and new tools. Lung ultrasonography (LUS) is an emerging method to assess pulmonary congestion. Accordingly, we describe the additive prognostic role of chest ultrasound with respect to traditional clinical and X-ray assessment in acute and chronic HF setting.

scholarly journals An Adult Mouse Model of Dilated Cardiomyopathy Caused by Inducible Cardiac-Specific Bis Deletion

2021 ◽  
Vol 22 (3) ◽  
pp. 1343
Author(s):  
Hye Hyeon Yun ◽  
Soon Young Jung ◽  
Bong Woo Park ◽  
Ji Seung Ko ◽  
Kyunghyun Yoo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Dilated Cardiomyopathy ◽  
Late Onset ◽  
Small Heat Shock Protein ◽  
Left Ventricular ◽  
Therapeutic Interventions ◽  
Ventricular Contractility ◽  
Knock Out ◽  
Multifunctional Protein ◽  
Cell Death Suppressor

BCL-2 interacting cell death suppressor (BIS) is a multifunctional protein that has been implicated in cancer and myopathy. Various mutations of the BIS gene have been identified as causative of cardiac dysfunction in some dilated cardiomyopathy (DCM) patients. This was recently verified in cardiac-specific knock-out (KO) mice. In this study, we developed tamoxifen-inducible cardiomyocyte-specific BIS-KO (Bis-iCKO) mice to assess the role of BIS in the adult heart using the Cre-loxP strategy. The disruption of the Bis gene led to impaired ventricular function and subsequent heart failure due to DCM, characterized by reduced left ventricular contractility and dilatation that were observed using serial echocardiography and histology. The development of DCM was confirmed by alterations in Z-disk integrity and increased expression of several mRNAs associated with heart failure and remodeling. Furthermore, aggregation of desmin was correlated with loss of small heat shock protein in the Bis-iCKO mice, indicating that BIS plays an essential role in the quality control of cardiac proteins, as has been suggested in constitutive cardiac-specific KO mice. Our cardiac-specific BIS-KO mice may be a useful model for developing therapeutic interventions for DCM, especially late-onset DCM, based on the distinct phenotypes and rapid progressions.

scholarly journals Remote monitoring in heart failure: current and emerging technologies in the context of the pandemic

Heart ◽  
2021 ◽  
Vol 107 (5) ◽  
pp. 366-372
Author(s):  
Donya Mohebali ◽  
Michelle M Kittleson
Keyword(s):  
Heart Failure ◽  
At Risk ◽  
Remote Monitoring ◽  
Reliable Method ◽  
Healthcare Delivery ◽  
Rapid Expansion ◽  
Monitoring Technology ◽  
Remote Healthcare ◽  
Monitoring Technologies

The incidence of heart failure (HF) remains high and patients with HF are at risk for frequent hospitalisations. Remote monitoring technologies may provide early indications of HF decompensation and potentially allow for optimisation of therapy to prevent HF hospitalisations. The need for reliable remote monitoring technology has never been greater as the COVID-19 pandemic has led to the rapid expansion of a new mode of healthcare delivery: the virtual visit. With the convergence of remote monitoring technologies and reliable method of remote healthcare delivery, an understanding of the role of both in the management of patients with HF is critical. In this review, we outline the evidence on current remote monitoring technologies in patients with HF and highlight how these advances may benefit patients in the context of the current pandemic.

Protocol for a block randomised controlled trial of an intervention to improve heart failure care

2016 ◽  
Vol 23 (4) ◽  
pp. 24-29 ◽  
Author(s):  
Hiba Deek ◽  
Phillip J Newton ◽  
Samar Noureddine ◽  
Sally C Inglis ◽  
Ghina Al Arab ◽  
...  
Keyword(s):  
Heart Failure ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Heart Failure Care ◽  
Randomised Controlled

Remote Specialty Therapeutic Management Enhances Patient-Centered Heart Failure Care in a Rural Community Setting

2015 ◽  
Vol 21 (8) ◽  
pp. S61
Author(s):  
Harleen Singh ◽  
Jessina C. McGregor ◽  
Cindy L. Quale ◽  
Kelsie W. Flynn ◽  
Samaneh Zhian ◽  
...  
Keyword(s):  
Heart Failure ◽  
Rural Community ◽  
Community Setting ◽  
Therapeutic Management ◽  
Patient Centered ◽  
Heart Failure Care

Relationship between self-care and comprehensive understanding of heart failure and its signs and symptoms

2017 ◽  
Vol 17 (6) ◽  
pp. 496-504 ◽  
Author(s):  
Kyoung Suk Lee ◽  
Debra K Moser ◽  
Kathleen Dracup
Keyword(s):  
Heart Failure ◽  
Confidence Interval ◽  
Self Care ◽  
Signs And Symptoms ◽  
Comprehensive Understanding ◽  
Behavior Scale ◽  
Heart Failure Exacerbation ◽  
The Relationship ◽  
Different Levels ◽  
Care Behavior

Background: Although incomplete understanding of heart failure and its signs and symptoms appears to be a barrier to successful self-care, there are few studies examining the relationship between self-care and levels of comprehensive understanding of heart failure and its signs and symptoms. Aim: To determine whether incomplete understanding of heart failure and its signs and symptoms is associated with self-care in heart failure patients who were recently discharged from the hospital due to heart failure exacerbation. Methods: Patients completed the nine-item European Heart Failure Self-care Behavior scale and questionnaire to assess knowledge of heart failure and its signs and symptoms. Three groups were formed by their different levels of understanding of heart failure and its signs and symptoms. Multivariable linear regression was used to determine whether these three levels of understanding groups predicted self-care after controlling for demographic and clinical variables. Results: Of 571 patients 22.1%, 40.1% and 37.8% had poor, moderate, and complete understanding, respectively. Compared with patients in the poor understanding group, patients in complete and moderate understanding groups were more likely to have better adherence to self-care activities (standardized β = −0.14, 95% confidence interval −3.41, −0.47; standardized β = −0.19, 95% confidence interval −4.26, −1.23, respectively). Conclusions: Fewer than half of the patients had a comprehensive understanding of heart failure and its signs and symptoms, which was associated with poor self-care. Our study suggests that patient education should include contents to promote comprehensive understanding of heart failure and its symptoms, as well as the importance of self-care behaviors.

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