Key result
mHealth teleintervention cuts 6-month CV death or HF decompensation vs usual care across all LVEF.
Why the study?
Incorporating mHealth into HF management programs may improve clinical outcomes, but it remained unclear whether this benefit is consistent across HFrEF, HFmrEF, and HFpEF phenotypes.
Does an mHealth intervention combining telemonitoring and teleintervention via videoconferencing reduce the composite of cardiovascular death or heart failure decompensation across LVEF phenotypes in patients recently discharged after heart failure worsening?
RCT (n=506)
Open-label with blinded adjudication of clinical events
Randomized at hospital discharge
Yes
Does an mHealth intervention combining telemonitoring and teleintervention via videoconferencing reduce the composite of cardiovascular death or heart failure decompensation across LVEF phenotypes in patients recently discharged after heart failure worsening?
Integration of mHealth into heart failure management programs following hospital discharge reduces fatal and non-fatal cardiovascular events consistently across HFrEF, HFmrEF, and HFpEF phenotypes.
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“These data reinforce the need to incorporate telemedicine technologies into clinical guidelines for the treatment of heart failure, especially in highly vulnerable patients. It is a safe, scalable model capable of improving patients' quality of life, while alleviating the burden on the healthcare system,”
“It is a paradigm shift in health care: we have gone from reaction to proactivity, detecting decompensations before they worsen,”
Supports mHealth integration into post-discharge HF care across phenotypes; extends RCT evidence by confirming LVEF-independent benefit.
Background Recent studies have shown that incorporating digital health solutions—including mobile health (mHealth)—into heart failure (HF) management programs may improve clinical outcomes. However, it remains unclear whether this benefit is consistent across the different left ventricular ejection fraction (LVEF) phenotypes. This analysis aimed to evaluate the effectiveness of an mHealth-based intervention across the three LVEF groups: preserved (HFpEF), mildly reduced (HFmrEF), and reduced (HFrEF), and to compare it with usual care (UC). Purpose To assess whether an mHealth intervention improves the risk of cardiovascular (CV) death or HF decompensation across LVEF categories following a recent hospitalization for HF worsening. Methods We conducted a post-hoc analysis of the Heart failure Events reduction with Remote Monitoring and eHealth Support (HERMeS) trial, focusing on outcomes according to baseline LVEF. HERMeS was a multicenter, controlled, open-label trial with blinded adjudication of clinical events conducted in ten hospitals in Spain. The intervention combined telemonitoring and teleintervention through videoconferencing using mHealth tools in patients recently discharged after HF decompensation. Participants were randomized to mHealth or UC at hospital discharge and followed for 6 months. The primary endpoint for this analysis was the composite of CV death or HF decompensation (time to first event) at 6 months, stratified by baseline LVEF. Results A total of 506 patients were included (255 mHealth, 251 UC). Mean age was 73±13 years, and 41% were women. Overall, 45% had HFrEF, 13% HFmrEF, and 42% HFpEF. Across all LVEF subgroups, mHealth showed a consistent benefit independent of baseline LVEF (interaction p>0.05), with the greatest effect observed in the HFrEF group. Only in the HFmrEF subgroup the difference between mHealth and UC did not reach statistical significance, although a trend toward event reduction with mHealth was observed. Conclusions Integration of mHealth into HF programs effectively reduces fatal and non-fatal CV events across all HF phenotypes, independently of LVEF.lvef--image.pngtable3.png
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Riverola et al. (2026) conducted an RCT in Heart failure across left ventricular ejection fraction (LVEF) phenotypes (n=506). mHealth-based telemonitoring and teleintervention via videoconferencing vs. Usual care was evaluated on Composite of cardiovascular death or heart failure decompensation (time to first event) at 6 months (p=>0.05 for interaction). mHealth telemonitoring and teleintervention consistently reduced 6-month CV death or HF decompensation versus usual care independent of baseline LVEF (interaction p>0.05).
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