通过真实世界HeartLogicTM警报响应减少心力衰竭住院人数——日本的一项多中心研究
{"_":"Reduction in Heart Failure Hospitalizations Through Real-World HeartLogic Alert Response - A Multicenter Study in Japan.","sup":["TM"]}
摘要(中文译文)
心力衰竭（HF）是一种进行性疾病，其特征是随着时间推移住院发生率不断上升。HeartLogic（HL）是一种多参数远程监测系统，旨在检测心力衰竭失代偿的早期征象。本研究利用多中心数据库，在真实世界环境中评估对HL警报的响应是否能减少心力衰竭相关住院。我们回顾性分析了日本8个中心植入具备HL功能的植入式心律转复除颤器或心脏再同步治疗除颤器的246例患者。患者被分为警报响应组（AR；n=167）和无响应组（NR；n=79）。警报响应包括多学科评估和电话分诊以确定是否需要临床就诊。比较了警报关闭期（激活前）和警报开启期（警报激活后）的心力衰竭住院率。在警报关闭期，648人年中发生50次住院（每1000人年77.1次）；在警报开启期，498人年中发生91次住院（每1000人年182.6次）。从警报关闭期到警报开启期，NR组的心力衰竭住院增加了3.24倍（95%置信区间[CI] 1.63-6.41），而AR组仅增加1.28倍（95% CI 0.81-2.03）。AR组心力衰竭住院的相对增加显著减弱（校正相对比0.40；95% CI 0.18-0.89；P=0.025）。尽管心力衰竭相关住院随着疾病进展而逐步增加，但真实世界中的警报响应可能在临床实践中减少住院和医疗费用。
Abstract
Heart failure (HF) is a progressive disease characterized by an increasing incidence of hospitalization over time. HeartLogic(HL) is a multiparametric remote monitoring system designed to detect early signs of HF decompensation. Using a multicenter database, this real-world study evaluated whether responses to HL alerts could reduce HF-related hospitalization. We retrospectively analyzed 246 patients implanted with an HL-enabled implantable cardioverter-defibrillator or cardiac resynchronization therapy defibrillator across 8 Japanese centers. Patients were categorized as alert-responsive (AR; n=167) or non-responsive (NR; n=79). Alert responses included multidisciplinary review and telephone triage to determine the need for clinical visits. HF hospitalization rates during the alert-off (before activation) and the alert-on (after alert activation) periods were compared. During the alert-off period, 50 hospitalizations occurred over 648 person-years (77.1 per 1,000 person-years); during the alert-on, 91 hospitalizations occurred over 498 person-years (182.6 per 1,000 person-years). From the alert-off to the alert-on period, HF hospitalization increased 3.24-fold (95% confidence interval [CI] 1.63-6.41) in the NR group, but only 1.28-fold (95% CI 0.81-2.03) in the AR group. The relative increase in HF hospitalization was significantly attenuated in the AR group (adjusted relative ratio 0.40; 95% CI 0.18-0.89; P=0.025). Although HF-related hospitalizations progressively increase as the disease advances, real-world alert responses may reduce hospitalizations and healthcare costs in clinical practice.
如何引用
AMA
Takafumi Oka, Mitsuyoshi Takahara, Shohei Kataoka, Michio Nagashima, Koumei Onuki, Daigo Yagishita, et al. {"_":"Reduction in Heart Failure Hospitalizations Through Real-World HeartLogic Alert Response - A Multicenter Study in Japan.","sup":["TM"]}. Circulation journal : official journal of the Japanese Circulation Society. 2026; doi:10.1253/circj.CJ-26-0182.
APA
Takafumi Oka, Mitsuyoshi Takahara, Shohei Kataoka, Michio Nagashima, Koumei Onuki, Daigo Yagishita, et al (2026). {"_":"Reduction in Heart Failure Hospitalizations Through Real-World HeartLogic Alert Response - A Multicenter Study in Japan.","sup":["TM"]}. Circulation journal : official journal of the Japanese Circulation Society. https://doi.org/10.1253/circj.CJ-26-0182
GB/T 7714
Takafumi Oka, Mitsuyoshi Takahara, Shohei Kataoka, Michio Nagashima, Koumei Onuki, Daigo Yagishita, et al. {"_":"Reduction in Heart Failure Hospitalizations Through Real-World HeartLogic Alert Response - A Multicenter Study in Japan.","sup":["TM"]}[J]. Circulation journal : official journal of the Japanese Circulation Society, 2026 doi:10.1253/circj.CJ-26-0182.
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