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Prognostic Impact of Hybrid Comprehensive Telerehabilitation Regarding Diastolic Dysfunction in Patients with Heart Failure with Reduced Ejection Fraction-Subanalysis of the TELEREH-HF Randomized Clinical Trial.
Irzmanski, Robert; Glowczynska, Renata; Banach, Maciej; Szalewska, Dominika; Piotrowicz, Ryszard; Kowalik, Ilona; Pencina, Michael J; Zareba, Wojciech; Orzechowski, Piotr; Pluta, Slawomir; Kalarus, Zbigniew; Opolski, Grzegorz; Piotrowicz, Ewa.
  • Irzmanski R; Department of Internal Medicine and Cardiac Rehabilitation, Medical University of Lódz, 90-647 Lodz, Poland.
  • Glowczynska R; 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland.
  • Banach M; Department of Hypertension, Medical University of Lódz, 90-647 Lodz, Poland.
  • Szalewska D; Clinic of Rehabilitation Medicine, Faculty of Health Sciences, Medical University of Gdansk, 80-210 Gdansk, Poland.
  • Piotrowicz R; National Institute of Cardiology, 04-628 Warsaw, Poland.
  • Kowalik I; Warsaw Academy of Medical Rehabilitation, 01-234 Warsaw, Poland.
  • Pencina MJ; National Institute of Cardiology, 04-628 Warsaw, Poland.
  • Zareba W; The Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC 27710, USA.
  • Orzechowski P; Cardiology Unit of the Department of Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA.
  • Pluta S; Telecardiology Center, National Institute of Cardiology, 04-628 Warsaw, Poland.
  • Kalarus Z; Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Silesian Center for Heart Diseases, Silesian Medical University, 41-800 Zabrze, Poland.
  • Opolski G; Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Silesian Center for Heart Diseases, Silesian Medical University, 41-800 Zabrze, Poland.
  • Piotrowicz E; 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland.
J Clin Med ; 11(7)2022 Mar 26.
Article in English | MEDLINE | ID: covidwho-1785765
ABSTRACT

AIMS:

The objective of the study was to evaluate the effects of individually prescribed hybrid comprehensive telerehabilitation (HCTR) implemented at patients' homes on left ventricular (LV) diastolic function in heart failure (HF) patients. METHODS AND

RESULTS:

The Telerehabilitation in Heart Failure Patients trial (TELEREH-HF) is a multicenter, prospective, randomized (11), open-label, parallel-group, controlled trial involving HF patients assigned either to HCTR involving a remotely monitored home training program in conjunction with usual care (HCTR group) or usual care only (UC group). The patient in the HCTR group underwent a 9-week HCTR program consisting of two stages an initial stage (1 week) conducted in hospital and the subsequent stage (eight weeks) of home-based HCTR five times weekly. Due to difficulties of proper assessment and differences in the evaluation of diastolic function in patients with atrial fibrillation, we included in our subanalysis only patients with sinus rhythm. Depending on the grade of diastolic dysfunction, patients were assigned to subgroups with mild diastolic (MDD) or severe diastolic dysfunction (SDD), both in HCTR (HCTR-MDD and HCTR-SDD) and UC groups (UC-MDD and UC-SDD). Changes from baseline to 9 weeks in echocardiographic parameters were seen only in A velocities in HCTR-MDD vs. UC-MDD; no significant shifts between groups of different diastolic dysfunction grades were observed after HCTR. All-cause mortality was higher in UC-SDD vs. UC-MDD with no difference between HCTR-SDD and HCTR-MDD. Higher probability of HF hospitalization was observed in HCTR-SDD than HCTR-MDD and in UC-SDD than UC-MDD. No differences in the probability of cardiovascular mortality and hospitalization were found.

CONCLUSIONS:

HCTR did not influence diastolic function in HF patients in a significant manner. The grade of diastolic dysfunction had an impact on mortality only in the UC group and HF hospitalization over a 12-24-month follow-up in HCTR and UC groups.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Language: English Year: 2022 Document Type: Article Affiliation country: Jcm11071844

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Language: English Year: 2022 Document Type: Article Affiliation country: Jcm11071844