Telemedicine digital phonocardiography: Cost-effective strategies in heart failure screening and monitoring

Abstract

Three studies were performed assessing the clinical value of digital electro- and phonocardiography (dECG, dPCG) with telemedicine application. In the first study, some Doppler echocardiographic parameters (ejection fraction, aortic Vmax, the grade of mitral and tricuspid regurgitation) were estimated from the spectral amplitude value of 170 time-frequency cells of the TriTest dPCG using multivariate discriminant analysis of 584 cardiac patients (292 for the training, and 292 for the test set). A cost analysis of heart failure (HF) screening in various populations was performed on 452 subjects. The greatest cost-savings (Euro / one HF patient) was found in the combined use of dECG and dPCG compared with the TE screening alone (mean: 82.4 CI-95%: 69.5-96.4 versus mean: 230.1 CI-95%: 196.5-254.4; p<0.001). In the third study, during the 24 months telemonitoring of serious heart failure patients, 124 hospital days charge was saved, comparing the two, 29-29 patientspsila groups.