Heart failure (HF) is a growing epidemic with the annual number of hospitalizations constantly increasing over the last decades for HF as a primary or secondary diagnosis. Despite the emergence of novel therapeutic approached that can prolong life and shorten hospital stay, HF patients will be needing rehospitalization and will often have a poor prognosis. Telemonitoring is a novel diagnostic modality that has been suggested to be beneficial for HF patients. Telemonitoring is viewed as a means of recording physiological data, such as body weight, heart rate, arterial blood pressure, and electrocardiogram recordings, by portable devices and transmitting these data remotely (via a telephone line, a mobile phone or a computer) to a server where they can be stored, reviewed and analyzed by the research team. In this systematic review of all randomized clinical trials evaluating telemonitoring in chronic HF, we aim to assess whether telemonitoring provides any substantial benefit in this patient population.
ErratumErratum to "The effectiveness of remote monitoring of elderly patients after hospitalisation for heart failure: The renewing health European project" [Int.
Two-dimensional transesophageal echocardiography (2D TEE) may fail to detect signs of infective endocarditis (IE) or to delineate complex anatomic lesions due to suboptimal visualization of the infected area. Three-dimensional (3D) TEE may have additional value; however, data are scarce. In 124 consecutive patients (85 M; Mean age 63 ± 14 years) with definite IE involving the aortic (36), mitral (35), tricuspid (5), ≤ 1 valve (6), and prosthetic valves (30),or pace-maker/ICD leads (12) the comparative analysis between 2D and 3D imaging focused on: 1) Presence and maximal dimension of vegetations; 2) Prediction of embolic events; 3) Location and dimension of valve perforation; 3) Prediction of successful mitral valve repair; 4) Identification and morphologic assessment of perivalvular complications.3D TEE detected more vegetations per patient (1.9 ± 2.1 vs 1.7± 1.6; p= 0.06), but this difference was significant only for vegetations on prosthetic valves and PM/ICD leads (2.2 ± 1.7 vs 1.1 ± 1.5; p=0.03). TomTec Software was used to crop the 3D volume to obtain the largest value for vegetations and perforation area. The 3D TEE maximal vegetation dimension was larger with a mean difference of 2.9 mm (95% CI, 1.9-4.52 mm) vs 2DTEE. The best cut-off value for prediction of embolic events was ≥18 mm with 3D TEE and ≥14 mm with 2D TEE. The positive predictive value for 3D TEE was not statistically higher (58% vs 52%). Valve perforation was identified in 10/19 patients with 2D TEE and in 18/19 patients with 3D TEE (p< 0.007) with subsequent surgical confirmation. Successful mitral valve repair was associated with a distance of the perforation > 3 mm from the leaflet tip and from commisures. This information was provided only by 3D TEE. Finally, 2D TEE missed 2/20 peri-annular extensions. After addition of 3D TEE all peri-annular extensions (20/20) were detected, without adding false positives.In 5 patients contrast 3D TEE provided visualization of the full extent of the defect and its precise anatomical location, prior to successful surgical resection. In conclusion 3D TEE is a feasible technique for the analysis of vegetation size and complex cardiac lesions caused by IE that may overcome the limitations of 2D TEE, providing incremental information useful for surgery
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.