Article Text


  1. T Mabote,
  2. A Torabi,
  3. R Dierckx,
  4. S Parsons,
  5. J Weston,
  6. J G F Cleland
  1. Hull York Medical School, University of Hull


    Background Home Telemonitoring may improve the management of patients with heart failure, reducing morbidity and mortality. Consequently, there is a growing interest in the use of non-invasive devices for remote monitoring of cardiovascular function. The physiological impact of environmental factors such as temperature on haemodynamic recordings in patients with heart failure has not been explored.

    Table 1

    Haemodynamic changes in the overall population

    Design and methods Patients with a clinical diagnosis of heart failure, receiving loop diuretics and with objective evidence of cardiac dysfunction were enrolled. A control group without heart failure was also enrolled. Continuous beat-to-beat pulse contour analysis was undertaken using finger-tip, volume-clamp (Nexfin, Bmeye, Netherlands) to measure haemodynamics on separate days at cool (19°C) and warm (28°C) room temperatures in the supine position and during light exercise.

    Results Haemodynamic data were obtained from a total of 12 men with stable heart failure (HF) aged between 46 and 90 years (mean, 72±13 years) and 6 patients (5 men and 1 woman) with hypertension (HTN) aged between 51 and 75 years (mean, 67±9 years). Mean LVEF was 32±12% while the median NT-proBNP was 1207 (IQR 431–3506) pg/ml in the HF cohort. Mean LVEF was 57±5% while median NT-proBNP was103 (IQR 48–178) pg/ml in the HTN group. Measurements at higher ambient temperatures induced vasodilation with a fall in BP and a rise in CI.

    Table 2

    Haemodynamic changes in the heart failure and control group

    Conclusions Changes in environmental temperature have marked effects on haemodynamics which can be detected non-invasively with telemonitoring devices. Local environmental conditions should be taken into account as they may be important for interpretation of data. Control of environmental temperature should be explored as a potential adjunct to therapy in patients with heart failure. Longer term studies are required to assess effects on fluid balance.

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