A scoping review on advancements in noninvasive wearable technology for heart failure management

npj Digital Medicine, Journal Year: 2024, Volume and Issue: 7(1)

Published: Oct. 12, 2024

Abstract Wearables offer a promising solution for enhancing remote monitoring (RM) of heart failure (HF) patients by tracking key physiological parameters. Despite their potential, clinical integration faces challenges due to the lack rigorous evaluations. This review aims summarize current evidence and assess readiness wearables practice using Medical Device Readiness Level (MDRL). A systematic search identified 99 studies from 3112 found articles, with only eight being randomized controlled trials. Accelerometery was most used measurement technique. Consumer-grade wearables, repurposed HF monitoring, dominated them in feasibility testing stage (MDRL 6). Only two described were specifically designed RM, received FDA approval. Consequently, actual impact on management remains uncertain limited robust evidence, posing significant barrier into care.

Language: Английский

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Non-invasive heart failure monitoring: leveraging smart scales and digital biomarkers to improve heart failure outcomes

Heart Failure Reviews, Journal Year: 2024, Volume and Issue: 29(5), P. 1145 - 1156

Published: July 23, 2024

Language: Английский

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Describing the use of remote dielectric sensing and handheld ultrasound in assessing lung congestion in heart failure patients within a primary care setting

European Journal of Cardiovascular Nursing, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 3, 2025

Abstract Thorough consideration of user experiences and the weighing advantages disadvantages are essential when implementing new technology in clinical practice. This article describes a primary care nurse’s experience using two technologies to monitor lung congestion six patient cases: remote dielectric sensing device for non-invasive fluid measurement portable handheld ultrasound device. Both can support decision-making assessing heart failure patients. However, technical difficulties interpretational complexities inherent their use. Balancing these finding effective strategies address challenges is crucial successful implementation.

Language: Английский

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Biomarkers for Congestion in Heart Failure: State-of-the-art and Future Directions

Cardiac failure review, Journal Year: 2025, Volume and Issue: 11

Published: Jan. 27, 2025

Congestion in patients with heart failure (HF) predicts adverse outcomes and is a leading cause of hospitalisation. Understanding congestion mechanisms helps HF management underscores the importance tailored therapies to treat vascular tissue congestion, improving patient outcomes. In this setting, several tools are available detect congestion. Biomarker measurement simple, valid affordable method evaluate HF. Natriuretic peptides most widely tool acute chronic HF, helping diagnosis, risk stratification management. Novel biomarkers can potentially become reliable allies diagnosing monitoring This review aims assess current scientific literature on for managing their clinical utility explore future perspectives field.

Language: Английский

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Remote dielectric sensing to detect pulmonary congestion in acute dyspnoeic patients: Reproducibility and the effect of pulmonary comorbidities

International Journal of Cardiology, Journal Year: 2025, Volume and Issue: unknown, P. 133068 - 133068

Published: Feb. 1, 2025

Remote Dielectric Sensing (ReDS) is a fast and non-invasive method that estimates lung fluid. We previously described moderate accuracies for ReDS to detect acute heart failure in consecutive patients. hypothesise unprecise values may stem from concomitant pulmonary diseases. To examine the reproducibility effect of comorbidities on dyspnoeic This prospective observational study included 97 patients ≥50 years with dyspnoea. Upon admission, underwent low-dose chest computed tomography (CT), echocardiography examination. by default performed right hemithorax sitting position. For comparisons, we conducted additional measurements two centimetres above below placement, supine Two blinded radiologists evaluated CT scans congestion Comparing three revealed coefficients variations 9.6 %, 8.2 8.3 %. versus comparison, coefficient variation was 9.5 % placement. Patients CT-verified had 5.9 while those without 10.3 In multivariable regression, lower were observed pneumonia (-1.81, p = 0.215, N 51), emphysema (-5.44, 0.001, 26), higher fibrosis (5.58, 0.032, 8) (5.79, 0.002, 17), compared without. fluid content affected showed consistent congestion.

Language: Английский

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Initial Experience of Noninvasive Quantification of Pulmonary Congestion Utilizing the Remote Dielectric Sensing System in Pediatric Patients with Heart Failure

Journal of Clinical Medicine, Journal Year: 2025, Volume and Issue: 14(4), P. 1292 - 1292

Published: Feb. 15, 2025

Background/Objectives: Remote dielectric sensing (ReDS) is a recently developed, noninvasive, electromagnetic energy-based technology designed to quantify pulmonary congestion without requiring expert techniques in adult patients with heart failure. However, its applicability pediatric remains unknown. Methods: ReDS values and chest X-rays were simultaneously obtained from history of Fontan surgery at an outpatient clinic. The Congestion Severity Index (CSI) was calculated analyze correlation values. Results: A total 21 (median age: 17 years; median height: 152.7 cm; weight: 48.6 kg; 12 male patients) included. successfully measured all participants any measurement mild observed between CSIs (r = 0.47, p 0.030). In exceeding 35% (N 11), stronger noted 0.61, 0.046). ≤ 10), exhibited wide distribution (25% 35%) despite low CSI Conclusions: system demonstrates potential as feasible for the noninvasive quantification patients, irrespective severity congestion. Notably, may have identify subclinical

Language: Английский

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The struggle is real! Measuring and managing heart failure congestion in the outpatient setting

European Journal of Cardiovascular Nursing, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 25, 2025

Language: Английский

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Device-based therapies for heart failure with preserved ejection fraction

Heart Failure Reviews, Journal Year: 2025, Volume and Issue: unknown

Published: April 4, 2025

Language: Английский

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Remote dielectric sensing predicts elevated left atrial pressure in patients with atrial fibrillation

IJC Heart & Vasculature, Journal Year: 2024, Volume and Issue: 53, P. 101459 - 101459

Published: July 5, 2024

There are currently no established non-invasive indices of echocardiography for elevated left atrial pressure (LAP) especially in patients with fibrillation (AF). Remote dielectric sensing (ReDS) is a novel electromagnetic energy-based technology that quantifies total lung fluid, enabling the monitoring volume status heart failure. The utility ReDS estimating LAP AF remains unknown. We prospectively investigated whom was directly measured during catheter ablation AF, and measurements were conducted day before ablation. Elevated defined as ≥ 15 mmHg. A 61 included (median age 66 years, 38 % female). Among them, 26 had LAP. positive correlation between (r = 0.363, P 0.004). Receiver operating characteristic curve analysis prediction demonstrated best cut-off value 30 %, sensitivity 65 specificity 69 an area under 0.703 (95 confidence interval 0.568–0.837). Multivariate logistic regression revealed independent predictor LAP, among covariates including ventricular ejection fraction, ratio early transmitral flow velocity to septal mitral annular diastolic velocity, index. Our results suggest could be valuable marker even AF. Further studies needed elucidate effectiveness ReDS-guided decongestive strategy

Language: Английский

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Do we need more tools or better tools to assess congestion?

ESC Heart Failure, Journal Year: 2024, Volume and Issue: 11(5), P. 2481 - 2483

Published: July 9, 2024

Assessing congestion is an essential part of taking care heart failure patients. Congestion causes debilitating symptoms and increases the risk short-term clinical deterioration.1 It a key pathophysiological condition, determining need for hospitalization, but also strongly associated with prognosis, especially when presented at discharge.2 Research to date has demonstrated safety effectiveness congestion-targeted treatment in failure.3, 4 Therefore, treating physician needs question presence or absence every patient contact. Although exam most commonly used method determine congestion, signs lack sufficient sensitivity specificity reliably diagnose quantify congestion. Various methods detection quantitative assessment come our aid, often non-invasive invasive, using implantable devices pulmonary artery. A chest X-ray readily available performed detect it neither sensitive nor specific enough be reliable diagnostic method.5 Echocardiography can provide estimates filling pressures tool phenotype failure. However, time-consuming variable availability across Europe. logistically impossible repeatedly perform echocardiography In addition, interpretation sometimes difficult, no single parameter detects congestion.6 Thus, not ideal follow-up recent years, different newer tools techniques have been introduced improve accuracy. With ultrasound, organ directly assessed quantified.2 This includes ultrasound lung, renal venous flow portal vein flow. scoring system called 'VExUS' recently proposed.7 The use these much less complex than requires suitable machine minimal training operator. implementation seems limited in-hospital specialized outpatient clinics. role routine practice still determined warrants further investigation. Implantable haemodynamic monitors are another more invasive aimed improving monitoring small sensor implanted artery side branch allows real-time measurement pressures. Patients asked daily measurements home, which sent unit. rise pressure indicates occurs days before develop.8 As such, clinicians intervene earlier avoid overt decompensation. These decade since pivotal CHAMPION trial was published 2011.9 patients New York Heart Association (NYHA) class III previous haemodynamic-guided therapy spectacular reduction around 40% urgent visits hospitalizations two large trials.9, 10 Real-world European data confirmed findings.11-13 device comes high costs, procedure yet reimbursed lot countries. Furthermore, there benefit severe disease state.14 At this stage, must emphasized that pressure-based do always reflect intravascular does equal volume.15 possible integrating many standard parameters, including assessment, laboratory tests from cardiac electronic available, would effective hospital post-hospital settings.16, 17 Remote dielectric sensing, ReDS, novel, assess uses radiofrequency-based (comparable radars) measure water content, expressed as percentage. radiofrequency wave generated patient's back transmitted through thorax lungs until reaches detector on opposite side. By analysing travel time power detected waves, lung fluid content calculated. takes 45 s top clothes. non-congested contains between 25% 35% water. higher percentage while lower dehydration. ReDS proven accurate, its might reduce 30 day events, shown proof-of-concept study.18 Izumida et al. studied prognostic value 133 admitted tertiary centre Japan.19 authors created 'ReDS ratio', comparing absolute admission discharge, numbers (<100%) indicating decrease (>100%) increase fluid. Unfortunately, chose express ratio percentage, inevitably leads confusion. Of note, majority had median 29%, 25th–75th percentile range 25%–33%. means least half normal (25%–35%). expected, > 100%, fluid, worse prognosis. added very questionable. Possibly, only differences and, above all, easier, by authors. Moreover, advantage precisely able just complicate interpretation. Apart fact, study demonstrates weakness conventional parameters follow up surprisingly, significant body weight and/or natriuretic peptide during course. loop diuretics, sodium–glucose cotransporter 2 inhibitors tolvaptan discharge. general, diuretics administered quite low entire population, may result suboptimal effects long-term Currently, treatment, drugs could explain why improvement measurements. should implemented early possible, started already acute phase aim rapidly achieve maximally tolerated doses. Adequately dosed symptoms, quality life prognosis significantly. High-intensity after event even safer beneficial elderly population.20 age cohort 78 years old, considerably older other studies field. Probably, others improved studies. An analysis kidney function hospitalization valuable element, unfortunately, were collected. Renal itself influence guidance remote efficient without chronic disease.21, 22 Concluding, interesting reproducible provides actionable information, warranting better new technologies measures way go management. Nevertheless, we tools; outcomes declare conflicts interest.

Language: Английский

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