Remote monitoring of patients with NYHA functional class II-III chronic heart failure using the M-Cardio mobile application in residents of Kyrgyzstan

Aim    Development and implementation of the M-Cardio mobile application for remote monitoring of patients with chronic heart failure (CHF) at the outpatient stage with an assessment of clinical effectiveness.
Material and methods        This study included 244 patients with NYHA functional class (FC) II-III CHF of ischemic etiology. During the inpatient phase, the patients were taught the basics of self-monitoring and self-care in CHF. In addition, patients of the main group were trained in using the M-Cardio mobile application. Patients were randomized into 2 groups: Group 1 was the main group, with further remote monitoring using the mobile application (n = 127), Group 2 was a control group, with standard outpatient monitoring at the patient’s residence (n = 117). The original version of the mobile application was downloaded to the smartphones of the participants in the main group. The app contained a developed algorithm of clinical indicators, which allows real-time assessment of the patient’s condition based on the quantitative deviations above or below threshold values. This algorithm includes 7 items, shortness of breath, position in bed, palpitation, edema, body weight, blood pressure (BP), and heart rate (HR), which the patient fills in twice a week or every day if necessary. A possibility is also included for automated information of the doctor and the patient to specify recommendations and timely adjust the treatment. The follow-up period was 12 months. 
Results        244 patients with NYHA FC II-III CHF of ischemic etiology were selected and enrolled in the study, including 155 (63.5%) men and 89 (36.5%) women (mean age, 61±7.4 years). NYHA FC II CHF was detected in 50 (20.4%) patients and NYHA FC III CHF in 194 (75.5%) patients. The mean left ventricular ejection fraction was 41.6±10.7%.
Conclusion    Preliminary results of the study indicated that the use of remote monitoring of CHF patients was significantly associated with an improvement in their quality of life, ability for self-care, and the functional status. The effectiveness of the M-Cardio mobile application in the remote monitoring of outpatients is based on a decreased frequency of rehospitalizations and an increased survival.

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