ABSTRACT
Objectives: This study is a randomized clinical trial aimed to investigate the effects of a home-based cardiac rehabilitation exercise program with social media-based supervision on NT-proBNP level and functional capacity of heart failure with reduced ejection fraction patients. Methods: We randomly recruited 25 subjects with left ventricle ejection fraction <40%, early after heart failure hospitalisation, resting heart rate <100 bpm, NYHA class I and II, and 6MWT entry test >100 m. Subjects were allocated into combination of hospital and home group (Control Group/CG) (n=12) and the home group under supervision of videocall telemonitor using WhatsApp (Intervention Group/IG) (n=13). Both groups got an exercise program 5 times / week, moderate intensity, 30 minutes per session for 4 weeks. The endpoint is a change in NTproBNP level and 6 minute walk distance (6MWD) at week 4 as a marker of increased functional capacity. Results: The groups have similar baseline characteristics. There was a significant decrease in NT-proBNP levels in IG and CG (2834±1546.39 pg/ mL and 3340±853.18 pg/mL, p=0.001 vs 0.041). Comparative analysis of changes in NT-proBNP level between the two groups did not show a significant difference (p=0.979). Post-intervention NT-proBNP levels in the IG group were 2553±778.86 pg/mL and CG group 2448.90±701.84 pg/mL, p=0.852. The 6MWT distance increased significantly in both groups (IG and CG 29.92±30.95 m vs 69.75±75.68 m, p=0.005 vs 0.009, respectively), mean increase in CG was higher than IG, but not significant (p=0.225). Postintervention 6MWD result of the IG was 340.92±109.38 m, and CG 378.42± 142.69 m, p=0.401. Conclusion: Home-based telemonitored cardiac rehabilitation with social media supervision (using WhatsApp) programs has comparable effectiveness as the combined cardiac rehabilitation program. In current COVID-19 pandemic, home-based telemonitored cardiac rehabilitation program can be implemented with similar benefit as conventional program.