Telemonitoring for Heart Failure Care: Feasibility and Early Clinical Impact of “Telecuore” Program

Background Telemedicine may improve heart failure (HF) management by enabling early detection of clinical instability and therapy optimization. The TeleCuore program was implemented at the Cardiology Unit of “Guglielmo da Saliceto” Hospital (Piacenza, Italy) to assess feasibility, clinical impact, and patient experience. Methods Patients discharged with de novo HF or chronic HF patients recently destabilized during follow–up were enrolled if digitally literate or supported by caregivers. A multidisciplinary team, led by a nurse case manager, provided education and multiparameter telemonitoring (blood pressure, heart rate, SpO2, weight, single–lead electrocardiogram [ECG]) via the AdiLife® platform, with centralized alert triage and shared management with cardiologists. Outcomes over a 9.3–month mean follow–up included therapy changes, clinical events, NT–proBNP and echocardiographic trends, and 6–month patient–reported outcomes. Results A total of 257 patients were included (mean age 70.6 years; HF with reduced [HFrEF] 57.6%, mildly reduced [HFmrEF] 24.9%, or preserved ejection fraction [HFpEF] 17.5%). Guideline–directed medical therapy (GDMT) increased, with higher SGLT2 inhibitor uptake and up–titration of sacubitril/valsartan. NT–proBNP decreased overall, significantly in HFpEF and de novo HFmrEF. Follow–up echocardiography showed significant improvement in ejection fraction (EF) for HFrEF (30.6±6.6% vs 38.6±9.6%; p‹0.001) and HFmrEF (44.5±2.2% vs 46.5±7.5%; p‹0.001). In HFpEF, while EF remained stable, diastolic function improved significantly (medial E/e’ ratio: 14.8±2.3 vs 12.9±2.1; p‹0.001). Clinical worsening occurred in 12.5% of patients: 56.2% were managed via teleconsultation or outpatient visits, while 43.8% required emergency department access. Programmed in–office visits were reduced by 30%. Patient satisfaction was high (9.02/10). Conclusion TeleCuore program proved feasible and well–accepted by patients and caregivers, enabling early detection of instability, supporting community–based management, and improving biomarkers and echocardiographic parameters, mainly due to strictly directed parameter control by the case manager. Comparative studies against usual care are warranted; a randomized trial is being prepared for next year.