5p(预测性、预防性、参与性、个性化和精准性)心血管医学的远程监测:COVID-19大流行期间的进展

Oleksiy Bashkirtsev, V. Gaevska, Z. Bilous, Liliia Lysa, O. Zimba
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引用次数: 0

摘要

2019年新型冠状病毒病(COVID-19)已成为影响数十亿人生活的全球大流行病。临床研究报告了COVID-19与心脏病之间的关联。由可穿戴传感器驱动的远程监控通过实现诊所外的健康监控来影响医疗保健。可穿戴设备可以对心电图、心率变异性、动脉血压、血氧饱和度和呼吸频率进行无创、连续的多参数评估。这种监测可能有助于预测和预防与COVID-19相关的心血管事件,满足了对新型5P(预测性、预防性、参与性、个性化和精准性)医学方法日益增长的需求。本文旨在综述可穿戴式心脏监测设备的现状和未来进展,以及在COVID-19大流行期间的临床应用进展。我们使用全球最大、组织有序的书目数据库Scopus进行文献计量分析,分析了该领域被引次数最多的文章。我们的分析包括基于可穿戴个性化设备的以心血管疾病为重点的远程患者监测技术的最广泛的实际影响的概述。分析中包括对covid - 19相关病症和一般病例的评估。最近的研究报告称,19.7- 27.8%的COVID-19住院患者存在心脏异常。与COVID-19相关的心肌炎和心率异常经常发生。此外,既往存在心血管疾病和高血压的患者预后更差。几项研究的数据已经确定心房颤动是COVID-19患者中最常见的心律失常形式。COVID-19患者现有房颤的恶化也是一个严重的临床问题。实施可穿戴式心电设备进行远程监护,可以改善对房颤患者及房颤高危人群的管理。基于可穿戴设备和远程监测的远程心电学可以实现对COVID-19患者和急性心血管事件高风险慢性病患者的院外控制,确保其早期发现和跟踪。
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REMOTE MONITORING FOR 5P (PREDICTIVE, PREVENTIVE, PARTICIPATORY, PERSONALIZED, AND PRECISION) CARDIOVASCULAR MEDICINE: PROGRESS AMIDST COVID-19 PANDEMIC
The novel coronavirus disease 2019 (COVID-19) has emerged as a global pandemic that has affected the lives of billions of people. Clinical studies have reported an association between COVID-19 and cardiac diseases. Remote monitoring powered by wearable sensors impacts medical care by enabling health monitoring outside of the clinic. Wearable devices can provide a noninvasive and continuous multi-parameter assessment of ECG, Heart Rate Variability, arterial blood pressure, oxygen saturation and respiratory rate evaluation. Such monitoring may help predict and prevent cardiovascular events related to COVID-19 addresses the growing demand for a novel 5P (Predictive, Preventive, Participatory, Personalized, and Precision) medicine approach. This article aimed to review current and prospective advances in wearable devices for cardiac monitoring and their progress toward clinical application during the COVID-19 pandemic. We performed bibliometric analysis by Scopus, the largest and well organized bibliographic database and analyzed the top-cited articles in this field. Our analysis includes an overview of the most widespread practical implications of CVD-focused remote patient monitoring techniques based on wearable personalized devices. Assessment for both COVID-related conditions and general cases is included in the analysis. Recent studies have reported that cardiac abnormalities present in 19.7-27.8 % of hospitalized patients with COVID-19. COVID-19 associated myocarditis and heart rate abnormalities frequently occur. Additionally, patients with pre-existing CVD and hypertension are at high risk of worse outcomes. Data from several studies have identified atrial fibrillation as the most common form of arrhythmias in COVID-19 patients. Worsening of existing atrial fibrillation in COVID-19 patients is also a serious clinical concern. Implementation of wearable ECG devices for remote monitoring can improve the management of patients with atrial fibrillation and those at high risk for its development. Telecardiology based on wearable devices and remote monitoring allow out-of-hospital control of COVID-19 patients and patients suffering from chronic diseases at high risk of acute cardiovascular events, ensuring their early detection and tracking.
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