Evidence map›Paper›PMID 37751276›Full record

ArticleJournal of medical Internet research2023

Effect of Telehealth Services on Mitral and Tricuspid Regurgitation Progression: Retrospective Study.

Li-Tan Yang, Jen-Kuang Lee, Chieh-Mei Tsai, Ying-Hsien Chen, Ching-Chang Huang, Hui-Wen Wu, Chin-Hua Su, Chien-Chang Lee, Chi-Sheng Hung, Yi-Lwun Ho

Erratum issuedOpen access · goldAbstract read
In one paragraph

Article in Journal of medical Internet research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.7field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Li-Tan YangDivision of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.ORCID 0000-0002-6341-5735
Jen-Kuang LeeDivision of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.ORCID 0000-0003-3790-484X
Chieh-Mei TsaiDivision of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.ORCID 0000-0002-8052-6664
Ying-Hsien ChenDivision of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.ORCID 0000-0003-2746-4967
Ching-Chang HuangDivision of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.ORCID 0000-0001-8733-6217
Hui-Wen WuTelehealth Center, National Taiwan University Hospital, Taipei, Taiwan.ORCID 0000-0002-4565-250X
Chin-Hua SuDepartment of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan.ORCID 0000-0003-4342-9926
Chien-Chang LeeDepartment of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan.ORCID 0000-0002-1243-2463
Chi-Sheng HungDepartment of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.ORCID 0000-0002-0158-7232
Yi-Lwun HoDivision of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.ORCID 0000-0002-8936-9570
National Taiwan University · TWNational Taiwan University Hospital · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMitral regurgitation (MR) and tricuspid regurgitation (TR) are common cardiac conditions with high mortality risks, which can be improved through early intervention. Telehealth services, which allow for remote monitoring of patient conditions, have been proven to improve the health management of chronic diseases, but the effects on MR and TR progression are unknown.

objectiveThis study aimed to explore whether patients receiving telehealth services have less MR and TR progression compared with a control group. We also aimed to identify the determinants of MR and TR progression.

methodsThis single-center retrospective study conducted at the National Taiwan University Hospital compared MR and TR progression (defined as either progression to moderate or greater MR and TR or MR and TR progression by ≥2 grades during the study period) between the telehealth and control groups. Patients had a minimum of 2 transthoracic echocardiograms at least 6 months apart; baseline mild-moderate MR and TR or lower; and no prior surgeries on the mitral or tricuspid valve. Telehealth patients were defined as those who received telehealth services for at least 28 days within 3 months of baseline. Basic demographics, baseline blood pressure measurements, prescribed medication, and Charlson Comorbidity Index components were obtained for all patients.

resultsA total of 1081 patients (n=226 in the telehealth group and n=855 in the control group) were included in the study analyses. The telehealth group showed significantly lower baseline systolic blood pressure (P<.001), higher Charlson Comorbidity Index (P=.02), higher prevalence of prior myocardial infarction (P=.01) and heart failure (P<.001), higher beta-blocker (P=.03) and diuretic (P=.04) use, and lower nitrate use (P=.04). Both groups showed similar cardiac remodeling conditions at baseline. Telehealth was found to be neutral for both MR (hazard ratio 1.10, 95% CI 0.80-1.52; P=.52) and TR (hazard ratio 1.27, 95% CI 0.92-1.74; P=.14) progression. Determinants for moderate or greater MR progression included older age, female sex, diuretic use, larger left atrial dimension, left ventricular end-diastolic dimension, left ventricular end-systolic dimension, and lower left ventricular ejection fraction. Determinants of moderate or greater TR progression included older age, female sex, diuretic use, presence of atrial fibrillation, LA dimension, left ventricular end-systolic dimension, and lower left ventricular ejection fraction; statin use was found to be protective.

conclusionsThis is the first study to assess the association between telehealth services and the progression of MR and TR. Telehealth patients, who had more comorbidities, displayed similar MR and TR progression versus control patients, indicating that telehealth may slow MR and TR progression. Determinants of MR and TR progression included easy-to-measure traditional echo parameters of cardiac function, older age, female sex, and atrial fibrillation, which can be incorporated into a telehealth platform and advanced alert system, improving patient outcomes through personalized care.

Indexed as

Atrial FibrillationTricuspid Valve InsufficiencyDiureticsFemaleHumansRetrospective StudiesStroke VolumeVentricular Function, LeftDiureticscardiaccardiologycardiovascular healthhealth managementheart diseasemitral regurgitationpatience carepatient-reported outcomepoint-of-care ultrasoundremote monitoringtelehealthtelemedicinetricuspid regurgitation

Identifiers

PMID37751276
PMCPMC10565617
OpenAlexW4385450304

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.