Long-term monitoring of respiratory rate in patients with heart failure: the Multiparametric Heart Failure Evaluation in Implantable Cardioverter-Defibrillator Patients (MULTITUDE-HF) study

Autor: Filippo Lamberti, Valentina Ribatti, Massimiliano Campoli, Giovanni B. Forleo, Sergio Valsecchi, Luca Santini, Giovanni Carreras, Mario Malavasi, Maurizio Menichelli, Umberto Riva, Andrea Natale, Luigi Di Biase, Francesco Romeo, Serafino Orazi, Mariolina Lovecchio, Alberto Scaccia
Rok vydání: 2015
Předmět:
Zdroj: Journal of Interventional Cardiac Electrophysiology. 43:135-144
ISSN: 1572-8595
1383-875X
DOI: 10.1007/s10840-015-0007-3
Popis: Monitoring respiratory rate (RR) is recommended at the time of hospital presentation for acute decompensation in heart failure (HF). Device-based continuous monitoring of RR may be helpful for diagnostic and prognostic stratification after implantable cardioverter-defibrillator (ICD) implantation. This study was undertaken to analyze short- and long-term changes in ICD-measured RR and to relate RR with the patient's clinical status and the occurrence of HF events.One hundred twenty-four consecutive HF patients who received ICD endowed with this diagnostic capability (Boston Scientific Inc., Natick, MA, USA) were prospectively enrolled. Patients were followed up for 12 months.At the baseline, the proportion of New York Heart Association (NYHA) class III-IV was higher among patients with daily maximum RR27 breaths/min (third tertile) than those with24 breaths/min (first tertile) (43 vs. 23%, p 0.05). Moreover, the ejection fraction was lower (27 ± 7 vs. 34 ± 8%, p 0.05). In patients with HF hospitalizations (33 events) and urgent visits for HF (15 events), the weekly average of RR calculated over the 7 days preceding hospital accesses did not differ from values recorded at the baseline and before scheduled follow-up visits. However, the weekly variation in RR (i.e., the difference between maximum and minimum values collected over the week) was significantly higher prior to hospitalization (p 0.05). A weekly variation3 breaths/min in maximum RR predicted an impending hospital admission for HF with sensitivity of 73 % and specificity of 57%.In this study, elevated values of ICD-monitored RR identified patients with worse functional status and lower systolic function. The weekly variation in RR increased before HF exacerbation. This monitoring technology may represent a useful tool in the clinical management of patients with HF.
Databáze: OpenAIRE
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