Remote monitoring of patients with chronic heart failure class II-III (NYHA) using the mobile application 'M-cardio' in residents of Kyrgyzstan

Abstract

Abstract Background This study aimed to assess the impact of remote monitoring through the "M-cardio" mobile application on patients with chronic heart failure (CHF) of NYHA class II-III, particularly those of ischemic etiology, residing in Kyrgyzstan. Methods A total of 244 patients with NYHA class II-III heart failure due to ischemic etiology were included in the study. During the inpatient phase, patients underwent training on self-monitoring and self-help strategies for heart failure. The intervention group received additional training on using the "M-cardio" mobile application. Patients were randomized into two groups: 1) intervention group with remote monitoring using the mobile application (n=127), and 2) control group under standard outpatient observation at their residence (n=117). The intervention group used the mobile application with a developed algorithm for clinical indicators, allowing real-time assessment of the patient's condition. The observation period extended for 12 months. Results The study evaluated changes in quality of life (MLHFQ), self-care ability (EHFSBS), and physical activity tolerance (6MWT). Initially, there were no significant differences between the groups. However, improvements in quality of life and self-care ability in the intervention group were evident at 6 months and persisted up to 12 months (44.8 ± 6.7 points and 56.5 ± 7.9 points, p < 0.01, in the intervention and control groups, respectively). Significant differences were also observed in physical activity tolerance after 12 months (6MWT) - 319 ± 79 meters in the intervention group and 233 ± 64 meters in the control group (p < 0.001). Moreover, there was a notable decrease in the proportion of patients discontinuing essential medications in the intervention group compared to the control group, particularly in ACE inhibitors/ARBs and beta-blockers. Conclusions The preliminary results indicate that the "M-cardio" mobile application for remote monitoring significantly improved the quality of life, self-care capabilities, and functional status of heart failure patients. The application demonstrated effectiveness in reducing recurrent hospitalizations and enhancing medication adherence, suggesting its potential for improving long-term outcomes and survival.