Using Biosensors and Digital Biomarkers to Assess Response to Cardiac Rehabilitation: Observational Study.
6MWT
cardiovascular
rehabilitation
sensor
wearables
Journal
Journal of medical Internet research
ISSN: 1438-8871
Titre abrégé: J Med Internet Res
Pays: Canada
ID NLM: 100959882
Informations de publication
Date de publication:
20 05 2020
20 05 2020
Historique:
received:
07
12
2019
accepted:
10
04
2020
revised:
06
03
2020
entrez:
21
5
2020
pubmed:
21
5
2020
medline:
13
11
2020
Statut:
epublish
Résumé
Cardiac rehabilitation (CR) is known for its beneficial effects on functional capacity and is a key component within current cardiovascular disease management strategies. In addition, a larger increase in functional capacity is accompanied by better clinical outcomes. However, not all patients respond in a similar way to CR. Therefore, a patient-tailored approach to CR could open up the possibility to achieve an optimal increase in functional capacity in every patient. Before treatment can be optimized, the differences in response of patients in terms of cardiac adaptation to exercise should first be understood. In addition, digital biomarkers to steer CR need to be identified. The aim of the study was to investigate the difference in cardiac response between patients characterized by a clear improvement in functional capacity and patients showing only a minor improvement following CR therapy. A total of 129 patients in CR performed a 6-minute walking test (6MWT) at baseline and during four consecutive short-term follow-up tests while being equipped with a wearable electrocardiogram (ECG) device. The 6MWTs were used to evaluate functional capacity. Patients were divided into high- and low-response groups, based on the improvement in functional capacity during the CR program. Commonly used heart rate parameters and cardiac digital biomarkers representative of the heart rate behavior during the 6MWT and their evolution over time were investigated. All participating patients improved in functional capacity throughout the CR program (P<.001). The heart rate parameters, which are commonly used in practice, evolved differently for both groups throughout CR. The peak heart rate (HR This study showed that when using wearable sensor technology, the differences in response of patients to CR can be characterized by means of commonly used heart rate parameters and digital biomarkers that are representative of cardiac response to exercise. These digital biomarkers, derived by innovative analysis techniques, allow for more in-depth insights into the cardiac response of cardiac patients during standardized activity. These results open up the possibility to optimized and more patient-tailored treatment strategies and to potentially improve CR outcome.
Sections du résumé
BACKGROUND
Cardiac rehabilitation (CR) is known for its beneficial effects on functional capacity and is a key component within current cardiovascular disease management strategies. In addition, a larger increase in functional capacity is accompanied by better clinical outcomes. However, not all patients respond in a similar way to CR. Therefore, a patient-tailored approach to CR could open up the possibility to achieve an optimal increase in functional capacity in every patient. Before treatment can be optimized, the differences in response of patients in terms of cardiac adaptation to exercise should first be understood. In addition, digital biomarkers to steer CR need to be identified.
OBJECTIVE
The aim of the study was to investigate the difference in cardiac response between patients characterized by a clear improvement in functional capacity and patients showing only a minor improvement following CR therapy.
METHODS
A total of 129 patients in CR performed a 6-minute walking test (6MWT) at baseline and during four consecutive short-term follow-up tests while being equipped with a wearable electrocardiogram (ECG) device. The 6MWTs were used to evaluate functional capacity. Patients were divided into high- and low-response groups, based on the improvement in functional capacity during the CR program. Commonly used heart rate parameters and cardiac digital biomarkers representative of the heart rate behavior during the 6MWT and their evolution over time were investigated.
RESULTS
All participating patients improved in functional capacity throughout the CR program (P<.001). The heart rate parameters, which are commonly used in practice, evolved differently for both groups throughout CR. The peak heart rate (HR
CONCLUSIONS
This study showed that when using wearable sensor technology, the differences in response of patients to CR can be characterized by means of commonly used heart rate parameters and digital biomarkers that are representative of cardiac response to exercise. These digital biomarkers, derived by innovative analysis techniques, allow for more in-depth insights into the cardiac response of cardiac patients during standardized activity. These results open up the possibility to optimized and more patient-tailored treatment strategies and to potentially improve CR outcome.
Identifiants
pubmed: 32432552
pii: v22i5e17326
doi: 10.2196/17326
pmc: PMC7270861
doi:
Substances chimiques
Biomarkers
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e17326Informations de copyright
©Hélène De Cannière, Christophe JP Smeets, Melanie Schoutteten, Carolina Varon, Chris Van Hoof, Sabine Van Huffel, Willemijn Groenendaal, Pieter Vandervoort. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 20.05.2020.
Références
Nat Rev Cardiol. 2014 Oct;11(10):586-96
pubmed: 25027487
J Am Coll Cardiol. 2003 Dec 17;42(12):2139-43
pubmed: 14680741
Ann Phys Rehabil Med. 2017 Jan;60(1):43-49
pubmed: 26996956
Conf Proc IEEE Eng Med Biol Soc. 2012;2012:3151-4
pubmed: 23366594
J Am Heart Assoc. 2017 May 9;6(5):
pubmed: 28487388
Heart. 2006 Apr;92(4):481-6
pubmed: 16159968
Circulation. 2010 Jul 13;122(2):191-225
pubmed: 20585013
Circ Heart Fail. 2018 Aug;11(8):e004969
pubmed: 30354566
Eur J Heart Fail. 2008 Jan;10(1):96-101
pubmed: 18096432
Sports Med. 2017 Sep;47(9):1821-1845
pubmed: 28303543
Circulation. 2002 Aug 6;106(6):666-71
pubmed: 12163425
Res Sports Med. 2016;24(1):1-15
pubmed: 26289798
J Am Coll Cardiol. 2006 Sep 19;48(6):1250-6
pubmed: 16979014
Health Rep. 2011 Mar;22(1):7-14
pubmed: 21510585
Eur J Appl Physiol Occup Physiol. 1991;62(4):297-300
pubmed: 2044541
Neth Heart J. 2019 Jul;27(7-8):347-353
pubmed: 30977040
Circulation. 1996 Oct 1;94(7):1567-72
pubmed: 8840845
PLoS One. 2018 Jun 29;13(6):e0199509
pubmed: 29958282
J Am Coll Cardiol. 2019 Apr 2;73(12):1430-1443
pubmed: 30922474
Am Heart J. 2008 Aug;156(2):292-300
pubmed: 18657659
PLoS One. 2016 Aug 11;11(8):e0160644
pubmed: 27513333
Eur Heart J. 2016 Jul 14;37(27):2129-2200
pubmed: 27206819
Front Nutr. 2014 Jun 16;1:5
pubmed: 25988109
Am J Respir Crit Care Med. 2002 Jul 1;166(1):111-7
pubmed: 12091180
N Engl J Med. 2002 Mar 14;346(11):793-801
pubmed: 11893790
Eur J Appl Physiol Occup Physiol. 1992;65(1):8-12
pubmed: 1505545
Am Heart J. 2011 Oct;162(4):571-584.e2
pubmed: 21982647
Eur J Prev Cardiol. 2013 Aug;20(4):585-92
pubmed: 22492866
PLoS One. 2014 Dec 05;9(12):e114273
pubmed: 25479403
Rev Port Cardiol. 2017 Mar;36(3):169-176
pubmed: 28238477
Am J Cardiol. 1995 Nov 15;76(14):1014-9
pubmed: 7484853
Card Electrophysiol Rev. 2003 Jan;7(1):99-104
pubmed: 12766530
Eur J Heart Fail. 2018 Dec;20(12):1735-1743
pubmed: 30255969
J Am Coll Cardiol. 2013 Oct 15;62(16):e147-239
pubmed: 23747642
Circ Cardiovasc Qual Outcomes. 2018 Apr;11(4):e000037
pubmed: 29599285
Med Sci Sports Exerc. 2001 Jan;33(1):107-16
pubmed: 11194095
J Sports Med Phys Fitness. 2012 Aug;52(4):337-43
pubmed: 22828454
Eur J Prev Cardiol. 2019 Oct 4;:2047487319877716
pubmed: 31581819
Clin Physiol Funct Imaging. 2014 Sep;34(5):327-39
pubmed: 24237859
Circulation. 1989 Oct;80(4):769-81
pubmed: 2791242
Cochrane Database Syst Rev. 2017 Jun 30;6:CD007130
pubmed: 28665511