SPC365

Home Telemonitoring in Heart Failure: Real-World Clinical Outcomes and Biosignal Predictors of Events

Session: Sessão de Posters 10 - Cuidados modernos na insuficiência cardíaca: congestão, metabolismo e resultados
Speaker: Inês Amorim Cruz

Congress: CPC 2026
Topic: D. Heart Failure
Theme: 10. Chronic Heart Failure
Subtheme: 10.5 Chronic Heart Failure – Prevention
Session Type: Posters Eletrónicos
FP Number: ---
Authors: Inês Amorim Cruz; Tiago Filipe Aguiar; Carlos Oliveira Costa; Mariana S Silva; Luís Miguel Santos; J. Mesquita Bastos; José A. Santos; Ana Briosa

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><strong><span style="font-size:10.5pt">Background:</span></strong><span style="font-size:10.5pt"> Despite advances in therapy, heart failure (HF) continues to strain healthcare systems due to frequent outpatient follow-up and recurrent hospitalizations. Non-invasive home telemonitoring (hTM) may help address this challenge by improving follow-up, supporting adherence, and enabling earlier detection of HF decompensation. However, real-world evidence on its prognostic impact remains limited.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><strong><span style="font-size:10.5pt">Aim:</span></strong><span style="font-size:10.5pt"> To evaluate the clinical impact of a non-invasive hTM programme for HF and explore which biosignals best predict HF events.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><strong><span style="font-size:10.5pt">Methods: </span></strong><span style="font-size:10.5pt">In this retrospective study, all patients in our hTM programme were included (2020-2025). Clinical, biochemical, and cardiac parameters were compared across three timepoints: one year prior to enrolment, the first year of participation, and one year post-enrolment (based on the latest clinical evaluation at our centre). Logistic regression was used to assess the predictive value of biosignals.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><strong><span style="font-size:10.5pt">Results:</span></strong><span style="font-size:10.5pt"> Over a 5-year period, our hTM programme enrolled 44 patients - median age of 70 years [IQR 60-77], 23% women and 77% with coronary artery disease. Median time in the hTM programme was 37 months [IQR 12&ndash;59], with a total of 41170 biosignal entries.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><span style="font-size:10.5pt">HF hospitalizations decreased from 53 in the year before hTM to 23 in the first year, and to 8 among patients followed for more than one year. Emergency department (ED) visits followed a similar trend. The proportion of patients in NYHA class I increased from 38.6% to 56.8% in the first year of hTM, remaining stable thereafter (p=0.05, Figure 1A), and median LVEF improved from 33.5% to 44% (p=0.0007, Figure 1B). In terms of CV risk factors, LDL-cholesterol decreased from 92.5 mg/dL to 65 mg/dL (p=0.014, Figure 1C); and among patients with ischemic heart disease, the proportion achieving LDL &lt;55 mg/dL rose from 14.7% to 55.9%.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><span style="font-size:10.5pt">Of the 10221 alerts triggered on the hTM platform, only 29 (0.3%) were considered clinically significant; 69% of which were resolved remotely without an ED visit. Among all HF-related ED visits, only 33% were referred through hTM. Weight changes showed the strongest association with HF-related ED visits (OR = 5.76 [95%CI, 2.87-11.0], p&lt;0.001), followed by oxygen saturation and heart rate (Figure 1D). </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><strong><span style="font-size:10.5pt">Conclusions:</span></strong><span style="font-size:10.5pt"> Over a median follow-up of 37 months, our non-invasive home telemonitoring programme reduced HF hospitalisations and emergency department visits, alongside improvements in NYHA class, cardiac function and better cardiovascular risk-factor control. Among monitored parameters, weight, oxygen saturation, and heart rate were the most informative predictors of HF-related ED visits.</span></span></span></span></p>