Early Detection of Subclinical Worsening Heart Failure Using a Respiratory Stability Telemonitoring System
Abstract
BACKGROUND: Early detection of subclinical worsening heart failure (HF) is essential to enable timely, proactive treatment that may alter the clinical course and prevent hospitalization. This study demonstrates how early non-invasive telemonitoring of respiratory stability time (RST) can detect subclinical worsening HF. METHODS AND RESULTS: Daily RST was calculated automatically from all-night respiratory signals in 66 patients. Subclinical worsening was detected by declines in RST preceding overt worsening HF in the control group (blinded to RST; n=35) and in the RST group (RST monitored daily by clinicians; n=31). The RST recovery zone sufficient to avert hospitalization was determined by RST responses to treatment escalation for overt worsening HF. Two clinically relevant RST thresholds were identified: RST <20 s, indicating a high-risk zone for subclinical worsening preceding hospitalization; and RST ≥30 s, defining a recovery target zone associated with hospitalization avoidance. The duration of subclinical worsening HF from the onset of RST decline <20 s to overt worsening was 40.0 days in the control group. In contrast, the interval from the onset of overt worsening HF to hospitalization was markedly shorter (control group, 7.5 days; RST group, 8.0 days). CONCLUSIONS: Noninvasive RST telemonitoring enables early detection of the prolonged subclinical worsening phase of HF and provides a clinically actionable biological target for proactive intervention aimed at preventing HF-related hospitalization.
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BibTeX
@article{asanoi2026early,
title = {{Early Detection of Subclinical Worsening Heart Failure Using a Respiratory Stability Telemonitoring System}},
author = {Hidetsugu Asanoi and Yasushi Sakata and Koichiro Kinugawa and Hideo Fujita and Shin-ichi Momomura and Shigeru Toyota and Teruo Inoue and Takahiko Naruko and Moriaki Inoko and Tomomi Yamada and Yoshiki Sawa and Shigeru Miyagawa and on behalf of the ITMETHOD-HF-II Investigators},
journal = {Circulation Journal},
year = {2026},
month = oct,
doi = {10.1253/circj.cj-26-0227},
url = {https://www.jstage.jst.go.jp/article/circj/90/11/90_CJ-26-0227/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Early Detection of Subclinical Worsening Heart Failure Using a Respiratory Stability Telemonitoring System
AU - Hidetsugu Asanoi
AU - Yasushi Sakata
AU - Koichiro Kinugawa
AU - Hideo Fujita
AU - Shin-ichi Momomura
AU - Shigeru Toyota
AU - Teruo Inoue
AU - Takahiko Naruko
AU - Moriaki Inoko
AU - Tomomi Yamada
AU - Yoshiki Sawa
AU - Shigeru Miyagawa
AU - on behalf of the ITMETHOD-HF-II Investigators
PY - 2026
DA - 2026/10/23
JO - Circulation Journal
DO - 10.1253/circj.cj-26-0227
UR - https://www.jstage.jst.go.jp/article/circj/90/11/90_CJ-26-0227/_article
AB - BACKGROUND: Early detection of subclinical worsening heart failure (HF) is essential to enable timely, proactive treatment that may alter the clinical course and prevent hospitalization. This study demonstrates how early non-invasive telemonitoring of respiratory stability time (RST) can detect subclinical worsening HF. METHODS AND RESULTS: Daily RST was calculated automatically from all-night respiratory signals in 66 patients. Subclinical worsening was detected by declines in RST preceding overt worsening HF in the control group (blinded to RST; n=35) and in the RST group (RST monitored daily by clinicians; n=31). The RST recovery zone sufficient to avert hospitalization was determined by RST responses to treatment escalation for overt worsening HF. Two clinically relevant RST thresholds were identified: RST <20 s, indicating a high-risk zone for subclinical worsening preceding hospitalization; and RST ≥30 s, defining a recovery target zone associated with hospitalization avoidance. The duration of subclinical worsening HF from the onset of RST decline <20 s to overt worsening was 40.0 days in the control group. In contrast, the interval from the onset of overt worsening HF to hospitalization was markedly shorter (control group, 7.5 days; RST group, 8.0 days). CONCLUSIONS: Noninvasive RST telemonitoring enables early detection of the prolonged subclinical worsening phase of HF and provides a clinically actionable biological target for proactive intervention aimed at preventing HF-related hospitalization.
SN - 1347-4820
SN - 1346-9843
ER -