Heart failure non-invasive home telemonitoring systems: A systematic review.

BACKGROUND AND OBJECTIVE: Heart Failure (HF) is mostly a lifestyle-related disease that is suited to telemonitoring since patients' signs and symptoms can be assessed remotely by healthcare providers. Today, non-invasive telemonitoring programs are increasingly used in HF care to detect patients' deterioration. This study aims to review and assess the distinctive characteristics of the different telemonitoring systems (TMS) tested in HF patients through clinical trials (CTs). Discussing the impact of the evaluation results of these systems is also another objective of this work. METHODS: The search for CTs studies related to non-invasive home TMS in HF patients has been made in Cochrane Library. Research works of interest were limited to those articles published between 2005 and March 2019. RESULTS: A total of 24 CTs that fully met the inclusion criteria were included in the final review. The main functionalities of these TMS were analyzed and compared among them. Also, the monitored parameters and significant findings of each trial were described. CONCLUSIONS: This review shows a wide difference among available functionalities deployed by the reviewed systems. Most of them did not take into account the recommendations of HF management specialists, detailed in the evidence-based Clinical Practice Guidelines (CPGs) of the most relevant cardiology associations. Due to this, there is a wide variety of TMS, which makes a comparison among them difficult. However, the few systems that comply with the CPGs recommendations found promising results, suggesting that the design of TMS for the HF management should take into account the recommendations of specialists (CPGs).

Recently Approved and Under Investigation Drugs for Treating Patients with Heart Failure.

Heart Failure (HF) represents a leading cause of morbidity and mortality worldwide. Despite the recent advances in the treatment of this condition, patients´ prognosis remains unfavorable in most cases. Sacubitril/valsartan and ivabradine have been recently approved to improve clinical outcomes in patients with HF with reduced ejection fraction. Drugs under investigation for treating patients with HF encompass many novel mechanisms including vasoactive peptides, blocking inflammatory- mediators, natriuretic peptides, selective non-steroidal mineralocorticoid-receptor antagonists, myocardial ß3 adrenoreceptor agonists, inhibiting the cytochrome C/cardiolipin peroxidase complex, neuregulin-1/ErbB signaling and inhibiting late inward sodium current. The aim of this manuscript is to review the main drugs under investigation for the treatment of patients with HF and give perspectives for their implementation into clinical practice.