CONGRESS ABSTRACT

Aim: Telemedicine allows an intensive home monitoring of the most frail outpatients and a close control during the vulnerable post-discharge phase. Moreover, several meta-analyses have shown that telemedicine-supported care pathways are not only effective but also economically advantageous. The emerging problem of takeover of chronic pathologies such as heart failure or pulmonary hypertension (PH) and the increasingly limited healthcare resources could benefit from telemedicine. Purpose: To investigate the effects of a close follow up by televisit and nurse home visit  in an unselected population of patients affected by  heart failure reduced ejection fraction (HFrEF) or PH in a mountain area. Methods: From February 2024 to December 2024, we enrolled patients living in Ivrea and Cuorgnè district affected by a HFrEF or PH, either after hospitalization or followed up in outpatient care. The nurses conducted regular home visits (every week or two) to monitor vital signs and perform electrocardiograms. At the end of the second week (or in case of clinical necessity), a teleconsultation was held with the referring cardiologist.  Results: 13 patients were enrolled (mean 70 years +- 10), 12 with HFrEF  with a mean ejection fraction of 33%. 69% (9 patients) had chronic kidney disease, 30% (4 patients) were diabetics, 23% (3 patients) had chronic obstructive pulmonary disease. 7 patients (53%) had a defibrillator and everybody had remote control. About 85% (11/13 patients) assumed beta blockers and aldosteron antagonists, and the majority (7 patients, 53%) assumed renin-angiotensin-aldosteron inhibitors and gliflozin (8 patients, 61%); 46% of the patients were on vericiguat therapy because of a worsening clinical condition. During the follow-up, 42 nurse home visits and 13 televisit with the cardiologist were performed. We registered only 2 hospital admission for cardiac reasons (1 because of hypertensive crisis, 1 acute heart failure.) and two deaths (1 for  cardiogenic shock, 1 for an oncologic disease) Conclusion: These preliminary results show that the comprehensive management of patients with heart failure and multiple comorbidities, with the collaboration of dedicated healthcare workers and with the auxilium of telemedicine, can reduce hospitalizations and improve the therapeutic adherence.