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[SALUS] Remote monitoring of physiologic parameters and assessment of cardiovascular patients
Session:
Posters (Sessão 1 - Écran 7) - Saúde Digital e Economia da Saúde
Speaker:
João Brito
Congress:
CPC 2023
Topic:
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
Theme:
33. e-Cardiology / Digital Health
Subtheme:
33.4 Digital Health
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Joao Brito; Helena Fonseca; Rodrigo Leão; Sérgio Laranjo; Hugo Ferreira
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">The activity of the autonomic nervous system (ANS) results from the antagonistic effects of its sympathetic and parasympathetic components. They are responsible for the regulation of the heart rate and blood pressure in order to maintain homeostasis during physiological stress. Disturbances in this system have been associated with syncope or atrial fibrillation, for example. Therefore, the evaluation of the ANS is essential for diagnostic and prognostic purposes.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">To comprehensively assess the ANS at the hospital, we developed a wearable IoT device, SALUS, which measures heart rate (HR), various heart rate variability (HRV) parameters, the low to high frequency ratio (LF/HF), respiratory rate (RR), oxygen saturation (SpO2), and peripheral vascular resistance (PVR). We conducted this study to assess the reliability of this new device by comparing it to gold-standard devices in clinical practice.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">SALUS was tested in the Syncope Unit following the Frontal Tilt Test protocol with glycerol trinitrate applied to all consecutive patients admitted during May 2022. The Task Force Monitor (TFM) was used to collect HRV and PVR data, and the uMEC10 cardiac monitor was used for measuring HR and SpO2. All these parameters were compared with those measured by the SALUS in the first 5 minutes of the Tilt Test acquisition. Linear regression and Bland-Altman analysis (limits of agreement, LA= [+-1.96 x standard deviation], and bias) were used to evaluate the comparisons statistically.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Eleven patients were studied, representing a heterogeneous sample, as no exclusion criteria were defined for this pilot study. The results obtained for the values of HR (R^2=0.99; LA= [-0.53; 0.82] bpm; bias=0.15 bpm), SpO2 (R^2=0.83; LA= [-0.80; 1.24] %; bias=0.22%), and LF/HF (R^2=0.77; LA=[-0.33; 0.32]; bias=0) suggest a robust agreement between the parameters measured by SALUS and the reference devices. Regarding PVR, the agreement is weaker (R^2=0.43; LA= [-45.0; 594.6]; bias=274.8), as expected given the known variability of the TFM in determining these values and the individual variability, here possibly increased due to the clinical heterogeneity of the studied sample. However, the PVR results are thus promising, requiring studies with larger sample sizes to prove and establish SALUS as a first-line comprehensive tool for evaluating cardiovascular patients.</span></span></p>
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