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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Heart failure &#40;HF&#41; is a highly prevalent and increasingly present condition with a huge impact on several global healthcare dimensions&#46; HF hospitalizations are particularly burdensome and are among the leading concerns of HF health providers&#44; both related to the economic impact and the association with adverse outcomes&#46; In Europe&#44; the &#40;re&#41;admission rate at 12 months varies from 25&#46;9&#37; to 44&#37;<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">1&#44;2</span></a> and in the ESC Heart Failure Long Term Registry a medium 5&#46;5&#37; in-hospital mortality rate was observed&#40;ranging from 1&#46;8&#37; to 36&#46;1&#37; according to presenting clinical phenotype&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">2</span></a> highlighting the insufficiency of current approaches to disease management&#46; According to Gouveia et al&#46;&#44; in Portugal&#44; HF hospitalizations portended 39&#37; of direct HF-related costs in 2014&#44; corroborating the economic burden of HF hospitalization among us&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">3</span></a> Telehealth has been embraced as a practice to mitigate HF effects by allowing upstream detection of worsening clinical status&#46; This home-rendered medical care strategy encompasses a range of methods&#44; from structured self-monitoring telephone-based programs to sophisticated device remote monitoring&#46; A promising methodology that might be conceptually superior to stand-alone clinical appointments&#44; albeit with inherent limitations not easy to circumvent&#46; The difficult journey to where we are now illustrates this clearly&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Developing technologies using surrogate biomarkers for earlier detection of HF exacerbation may enable prompt adoption of stabilizing measures prior to overt clinical deterioration and avert the need for hospitalization&#46; This concept has triggered multiple approaches in recent years&#46; One of the first attempts explored technical breakthroughs affording automatic monitoring of physiological &#40;heart sounds&#44; respiration&#44; thoracic impedance&#44; heart rate&#44; patient activity&#41; and technical data &#40;arrhythmic burden&#44; pacing percentage&#44; inappropriate shocks&#44; lead sensing properties&#41; in implanted cardiac electronic devices &#40;CRT pacemakers&#44; defibrillators&#41;&#44; using single or multisensory based diagnostic algorithms&#46; This device-guided telemonitoring proved to be feasible and potentially incrementally beneficial&#46;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">4&#44;5</span></a> Yet&#44; clinical trials using implanted devices have not consistently shown clinical benefit in HF settings&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">6</span></a> At the heart of the problem might be finding the right biomarker or set of biomarkers to track rather than the specific idea of remote management&#46; Since filling pressures play a pivotal role in decompensating HF&#39;s pathophysiology&#44; it did not come as a surprise that monitoring some of their surrogate markers has been revealed as one of the most sound for that purpose&#46; Recent data show that remote hemodynamic-guided care&#44; tracking left atrial pressure&#44; pulmonary artery pressure or right ventricular pressures as estimates of filling pressures is undoubtedly beneficial in preventing HF hospitalizations&#44;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">7</span></a> validating the robustness and apparent superiority of the predictive value of these parameters&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">8</span></a> Of these&#44; sensing pulmonary artery pressure by CardioMEMS HF System &#40;Abbott&#44; Sylmar&#44; California&#41; seems to outperform other options having one of the most solid pieces of evidence in reducing HF hospitalizations&#44; with a remarkable more than 50&#37; drop&#44; regardless of HF phenotype &#40;either with a reduced or a preserved ejection fraction&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">9</span></a> Wearable devices&#44; defined as externally applied gadgets capable of sensing functional and physiological signals&#44; are newcomers to the HF arena as non-invasive alternatives to such technologies&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">In this issue of the <span class="elsevierStyleItalic">Journal</span>&#44; Martins et al&#46; present the rationale behind a proposed prototype of a wearable vest with an inbuilt multisensory system&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">10</span></a> In brief&#44; the authors integrate this device in a broader project of remote HF monitoring they intend to implement &#8211; the GENICA project&#46; Is this unprecedented&#63; Despite being an emerging approach&#44; they are not pioneers in this field&#46; As others have done previously&#44; they hypothesized that ambulatory non-invasive device-based capture&#44; collection&#44; transference&#44; and processing of biodata might be of value in HF care&#46; The efficacy of this non-invasive biodata streaming has not yet been entirely determined&#44; and the evidence in this setting is scarce&#46; Preliminary strategies using single-channel monitoring&#44; based on transthoracic bioimpedance obtained via a wearable vest&#44; have shown encouraging results&#46; The SENTINEL-HF trial reported 87&#37; sensitivity and 70&#37; specificity for identifying recurrent HF events&#44; the downside being significant data loss and patient withdrawal&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">11</span></a> Estimation of lung fluid content by dielectric sensing is another alternative under investigation&#46; Amir et al&#46;&#44; using remote dielectric sensing technology &#40;ReDS&#41;&#44; reported&#44; in an observational&#44; multicenter&#44; prospective study of 50 patients&#44; an 87&#37; reduction and a 79&#37; increase in hospitalization with ReDS-guided medical titration when compared&#44; respectively&#44; to the 90 days prior and the 90 days post-use of the vest&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">12</span></a> A prospective randomized clinical trial using this device in acute HF hospitalized patients is underway &#40;NCT03586336&#41;&#46; An analogous device&#44; targeting lung-fluid evaluation&#44; albeit with additional functionalities&#44; is being tested in a larger-scale clinical trial &#40;NCT03476187&#41; and will&#44; hopefully&#44; shed further light on this topic&#46; Furthermore&#44; novel metrics to assess cardiovascular hemodynamics and impending HF decompensation are emerging&#44; such as evaluation of seismocardiogram signals that rely on chest vibrations and leg bioimpedance measurements&#46;<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">13&#44;14</span></a> Nevertheless&#44; despite the heightened interest in these wearable vests&#44; there are no data on their real-world impact on HF hospitalizations&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The current trend on the toolbox of wearables in HF focuses on multiparameter systems&#46; The authors&#8217; proposal is part of this recent trend and has the potential to bring additional insights into this field&#46; The precursor MUSIC study comprised an external&#44; adherent&#44; multisensor system that had&#44; in the validation cohort&#44; 63&#37; sensitivity and 92&#37; specificity for detection of HF events&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">15</span></a> Recently&#44; Stehlik et al&#46; described the results of a wearable device similar to the authors&#44; also integrating a variety of sensors &#40;ECG&#44; heart rate&#44; respiratory rate&#44; body temperature&#44; activity level&#44; and body position&#41;&#44; tested in the LINK-HF study &#40;Multisensor Non-invasive Remote Monitoring for Prediction of Heart Failure Exacerbation&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">16</span></a> Using a machine learning algorithm&#44; the analytical platform tested demonstrated 76&#37; to 88&#37; sensitivity and an 85&#37; specificity to detect precursors of HF hospitalizations with median anticipation &#40;time from alert to readmission&#41; of 6&#46;5 days&#46; These results compare closely to those of implantable devices&#46; Likewise&#44; just a few months ago&#44; another analogous cloth-based diagnostic monitoring platform &#40;Wearable Congestive Heart Failure Management System - SimpleSENSE&#41; received FDA approval&#46; Its application in HF care is being tested in the validation NanoSENSE trial &#40;<span class="elsevierStyleItalic">NCT03719079</span>&#41;&#46; The device designed by the authors integrates a sizable number of biosensors targeting vital&#44; electrophysiological&#44; hemodynamic&#44; and chemical biosignals&#58; transthoracic impedance&#44; electrocardiographic data &#40;heart rate and heart rate variability&#44; T wave amplitude variability&#44; electric conduction abnormalities&#44; atrial and ventricular arrhythmias&#44; myocardial ischemia&#41;&#44; right atrial and left atrial pressures&#44; systemic arterial blood pressure&#44; pre-ejection period&#44; cardiac output&#44; peripheral oxygen saturation&#44; respiratory rate&#44; and skin sodium content&#44; along with patient&#39;s physical activity levels&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">In this paper&#44; the investigators explore the theoretical foundations for selecting these specific bioparameters&#46; Most of them are self-evident options&#44; whereas others are of questionable interest&#46; The complex interplay of pre-ejection period determinants alongside the redundant information it provides compared to other signals impairs its incremental diagnostic value with the disadvantage of adding intricacy to the analytical system&#46; The skin has increasingly been recognized to participate in the regulatory system of body sodium &#40;Na&#41; homeostasis&#46; Skin Na-storage role&#44; better studied in other conditions such as hypertension and chronic renal disease&#44; has little evidence in HF&#44; as acknowledged by the authors&#46; Hence&#44; the inclusion of a Na-sensor has the single merit of functioning as a research tool rather than an intervention-guiding parameter&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">One of the main difficulties that this prototype may encounter is feasibility&#46; Technical operability&#44; although challenging considering the number of sensors required&#44; is probably the easiest to circumvent&#46; The assembling of the enormous dataflow volume that such a system will generate is the ultimate challenge the authors face&#44; along with mapping out well-defined downstream healthcare delivery models to attain this approach&#39;s full potential&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">This device&#44; similar to others&#44; offers the possibility of reshaping the monitoring paradigm of HF ambulatory care&#46; However&#44; some caution is wise before becoming overenthusiastic&#46; Several obstacles&#44; beyond the technological ones&#44; must be overcome&#46; We are at a point in engineering informatics where remote collection and processing of data pose little difficulties&#44; and the level of precision is high&#46; Data overload is a concern&#44; but several upfront technical solutions integrating artificial intelligence-driven algorithms are already in place or on the horizon&#46; Contrarily&#44; most of the medical infrastructures and healthcare modus operandi face some inertia and are now surpassed by these technological innovations&#46; So&#44; converting those data into better clinical decision-making impacting HF outcomes is the actual task that the medical community has to handle&#46; Successful implementation of these interventions is dependent not only on appropriate patient selection and widespread availability&#44; but also on the effectiveness of the network of logistics and operationality set&#46; The inconsistent application of cardiac implantable electronic devices monitoring capabilities in HF care&#44; tracking almost the same biosignals as wearables&#44; clearly demonstrates this&#46; Lastly&#44; there are legal and ethical issues related to regulation and data security that have to be addressed&#46; In Europe&#44; strict regulatory systems require conformity with the CE marking &#40;EU Regulations 2017&#47;745 and 2020&#47;561&#41; and General Data Processing Regulation &#40;GDPR - EU Regulation 2016&#47;679&#41;&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">All things considered&#44; given modern HF care needs&#44; once proven valid and reliable&#44; it is foreseeable that these innovative wearable solutions will assuredly be well-received&#46; It is expected that their application will be efficacious&#44; provided they do not jeopardize intangibles variables such as quality-of-life and well-being&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">For the time being&#44; we are at the outset of this new frontier in HF management&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0050" class="elsevierStylePara elsevierViewall">The author has no conflicts of interest to declare&#46;</p></span></span>"
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              "identificador" => "bib0085"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "EURObservational Research Programme&#58; regional differences and 1-year follow-up results of the Heart Failure Pilot Survey &#40;ESC-HF Pilot&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "A&#46;P&#46; Maggioni"
                            1 => "U&#46; Dahlstr&#246;m"
                            2 => "G&#46; Filippatos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/eurjhf/hft050"
                      "Revista" => array:7 [
                        "tituloSerie" => "Eur J Heart Fail"
                        "fecha" => "2013"
                        "volumen" => "15"
                        "paginaInicial" => "808"
                        "paginaFinal" => "817"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23537547"
                            "web" => "Medline"
                          ]
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                          "pii" => "S1470204513700937"
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            1 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical phenotypes and outcome of patients hospitalized for acute heart failure&#58; the ESC Heart Failure Long-Term Registry"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "O&#46; Chioncel"
                            1 => "A&#46; Mebazaa"
                            2 => "V&#46;P&#46; Harjola"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/ejhf.890"
                      "Revista" => array:7 [
                        "tituloSerie" => "Eur J Heart Fail"
                        "fecha" => "2017"
                        "volumen" => "19"
                        "paginaInicial" => "1242"
                        "paginaFinal" => "1254"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28463462"
                            "web" => "Medline"
                          ]
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                          "pii" => "S1470204513704649"
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            2 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Current costs of heart failure in Portugal and expected increases due to population aging"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46;R&#46;A&#46; Gouveia"
                            1 => "R&#46; Ascen&#231;&#227;o"
                            2 => "F&#46; Fiorentino"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.repc.2019.09.006"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Port Cardiol"
                        "fecha" => "2020"
                        "volumen" => "39"
                        "paginaInicial" => "3"
                        "paginaFinal" => "11"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31973946"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Implant-based multiparameter telemonitoring of patients with heart failure &#40;IN-TIME&#41;&#58; a randomised controlled trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "G&#46; Hindricks"
                            1 => "M&#46; Taborsky"
                            2 => "M&#46; Glikson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(14)61176-4"
                      "Revista" => array:7 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2014"
                        "volumen" => "384"
                        "paginaInicial" => "583"
                        "paginaFinal" => "590"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25131977"
                            "web" => "Medline"
                          ]
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                          "pii" => "S1470204518307782"
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                          "issn" => "14702045"
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                  ]
                ]
              ]
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            4 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "5"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A multisensor algorithm predicts heart failure events in patients with implanted devices&#58; results from the MultiSENSE study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46;P&#46; Boehmer"
                            1 => "R&#46; Hariharan"
                            2 => "F&#46;G&#46; Devecchi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jchf.2016.12.011"
                      "Revista" => array:6 [
                        "tituloSerie" => "JACC Heart Fail"
                        "fecha" => "2017"
                        "volumen" => "5"
                        "paginaInicial" => "216"
                        "paginaFinal" => "225"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28254128"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Remote management of heart failure using implantable electronic devices"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46;M&#46; Morgan"
                            1 => "S&#46; Kitt"
                            2 => "J&#46; Gill"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/eurheartj/ehx227"
                      "Revista" => array:7 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2017"
                        "volumen" => "38"
                        "paginaInicial" => "2352"
                        "paginaFinal" => "2360"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28575235"
                            "web" => "Medline"
                          ]
                        ]
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                          "pii" => "S0302283817302774"
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                          "issn" => "03022838"
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                  ]
                ]
              ]
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              "identificador" => "bib0115"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Remote haemodynamic-guided care for patients with chronic heart failure&#58; a meta-analysis of completed trials"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "P&#46;B&#46; Adamson"
                            1 => "G&#46; Ginn"
                            2 => "S&#46;D&#46; Anker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/ejhf.638"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Heart Fail"
                        "fecha" => "2017"
                        "volumen" => "19"
                        "paginaInicial" => "426"
                        "paginaFinal" => "433"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27634736"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0120"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Device monitoring in heart failure management&#58; outcomes based on a systematic review and meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Halawa"
                            1 => "T&#46; Enezate"
                            2 => "G&#46; Flaker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.21037/cdt.2019.01.02"
                      "Revista" => array:6 [
                        "tituloSerie" => "Cardiovasc Diagn Ther"
                        "fecha" => "2019"
                        "volumen" => "9"
                        "paginaInicial" => "386"
                        "paginaFinal" => "393"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31555544"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lower rates of heart failure and all-cause hospitalizations during pulmonary artery pressure-guided therapy for ambulatory heart failure&#58; one-year outcomes from the CardioMEMS post-approval study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "D&#46;M&#46; Shavelle"
                            1 => "A&#46;S&#46; Desai"
                            2 => "W&#46;T&#46; Abraham"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCHEARTFAILURE.119.006863"
                      "Revista" => array:5 [
                        "tituloSerie" => "Circ Heart Fail"
                        "fecha" => "2020"
                        "volumen" => "13"
                        "paginaInicial" => "e006863"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32757642"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "MONITORIA&#58; starting a new era of ambulatory heart failure monitoring&#63; Part I &#8211; theoretical rationale"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "C&#46; Martins"
                            1 => "J&#46; Machado da Silva"
                            2 => "D&#46; Guimar&#227;es"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:3 [
                        "tituloSerie" => "Rev Port Cardiol"
                        "fecha" => "2021"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2631811"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bioimpedance-based heart failure deterioration prediction using a prototype fluid accumulation vest-mobile phone dyad&#58; an observational study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "C&#46;E&#46; Darling"
                            1 => "S&#46; Dovancescu"
                            2 => "J&#46;S&#46; Saczynski"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2196/cardio.6057"
                      "Revista" => array:5 [
                        "tituloSerie" => "JMIR Cardio"
                        "fecha" => "2017"
                        "volumen" => "1"
                        "paginaInicial" => "e1"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31758769"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluation of remote dielectric sensing &#40;ReDS&#41; technology-guided therapy for decreasing heart failure re-hospitalizations"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "O&#46; Amir"
                            1 => "T&#46; Ben-Gal"
                            2 => "J&#46;M&#46; Weinstein"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ijcard.2017.02.120"
                      "Revista" => array:7 [
                        "tituloSerie" => "Int J Cardiol"
                        "fecha" => "2017"
                        "volumen" => "240"
                        "paginaInicial" => "279"
                        "paginaFinal" => "284"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28341372"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0140673619307238"
                          "estado" => "S300"
                          "issn" => "01406736"
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                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Novel wearable seismocardiography and machine learning algorithms can assess clinical status of heart failure patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "O&#46;T&#46; Inan"
                            1 => "M&#46; Baran Pouyan"
                            2 => "A&#46;Q&#46; Javaid"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCHEARTFAILURE.117.004313"
                      "Revista" => array:5 [
                        "tituloSerie" => "Circ Heart Fail"
                        "fecha" => "2018"
                        "volumen" => "11"
                        "paginaInicial" => "e004313"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29330154"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bioimpedance and new-onset heart failure&#58; a longitudinal study of &#62;500 000 individuals from the general population"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "D&#46; Lindholm"
                            1 => "E&#46; Fukaya"
                            2 => "N&#46;J&#46; Leeper"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/JAHA.120.020143"
                      "Revista" => array:4 [
                        "tituloSerie" => "J Am Heart Assoc"
                        "fecha" => "2018"
                        "volumen" => "7&#46;"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33904317"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Design and performance of a multisensor heart failure monitoring algorithm&#58; results from the multisensor monitoring in congestive heart failure &#40;MUSIC&#41; study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "I&#46;S&#46; Anand"
                            1 => "W&#46;H&#46; Tang"
                            2 => "B&#46;H&#46; Greenberg"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.cardfail.2012.01.009"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Card Fail"
                        "fecha" => "2012"
                        "volumen" => "18"
                        "paginaInicial" => "289"
                        "paginaFinal" => "295"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22464769"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Continuous wearable monitoring analytics predict heart failure hospitalization&#58; the LINK-HF multicenter study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46; Stehlik"
                            1 => "C&#46; Schmalfuss"
                            2 => "B&#46; Bozkurt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCHEARTFAILURE.119.006513"
                      "Revista" => array:5 [
                        "tituloSerie" => "Circ Heart Fail"
                        "fecha" => "2020"
                        "volumen" => "13"
                        "paginaInicial" => "e006513"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32093506"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
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Editorial comment
Wearable remote monitoring in heart failure care – where do we stand?
Monitorização remota da insuficiência cardíaca com wearables – onde nos encontramos?
Sofia Cabrala,b
a Cardiology Department, Centro Hospitalar Universitário do Porto, Portugal
b Instituto de Ciências Biomédicas Abel Salazar, Porto University, Portugal
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Heart failure &#40;HF&#41; is a highly prevalent and increasingly present condition with a huge impact on several global healthcare dimensions&#46; HF hospitalizations are particularly burdensome and are among the leading concerns of HF health providers&#44; both related to the economic impact and the association with adverse outcomes&#46; In Europe&#44; the &#40;re&#41;admission rate at 12 months varies from 25&#46;9&#37; to 44&#37;<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">1&#44;2</span></a> and in the ESC Heart Failure Long Term Registry a medium 5&#46;5&#37; in-hospital mortality rate was observed&#40;ranging from 1&#46;8&#37; to 36&#46;1&#37; according to presenting clinical phenotype&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">2</span></a> highlighting the insufficiency of current approaches to disease management&#46; According to Gouveia et al&#46;&#44; in Portugal&#44; HF hospitalizations portended 39&#37; of direct HF-related costs in 2014&#44; corroborating the economic burden of HF hospitalization among us&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">3</span></a> Telehealth has been embraced as a practice to mitigate HF effects by allowing upstream detection of worsening clinical status&#46; This home-rendered medical care strategy encompasses a range of methods&#44; from structured self-monitoring telephone-based programs to sophisticated device remote monitoring&#46; A promising methodology that might be conceptually superior to stand-alone clinical appointments&#44; albeit with inherent limitations not easy to circumvent&#46; The difficult journey to where we are now illustrates this clearly&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Developing technologies using surrogate biomarkers for earlier detection of HF exacerbation may enable prompt adoption of stabilizing measures prior to overt clinical deterioration and avert the need for hospitalization&#46; This concept has triggered multiple approaches in recent years&#46; One of the first attempts explored technical breakthroughs affording automatic monitoring of physiological &#40;heart sounds&#44; respiration&#44; thoracic impedance&#44; heart rate&#44; patient activity&#41; and technical data &#40;arrhythmic burden&#44; pacing percentage&#44; inappropriate shocks&#44; lead sensing properties&#41; in implanted cardiac electronic devices &#40;CRT pacemakers&#44; defibrillators&#41;&#44; using single or multisensory based diagnostic algorithms&#46; This device-guided telemonitoring proved to be feasible and potentially incrementally beneficial&#46;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">4&#44;5</span></a> Yet&#44; clinical trials using implanted devices have not consistently shown clinical benefit in HF settings&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">6</span></a> At the heart of the problem might be finding the right biomarker or set of biomarkers to track rather than the specific idea of remote management&#46; Since filling pressures play a pivotal role in decompensating HF&#39;s pathophysiology&#44; it did not come as a surprise that monitoring some of their surrogate markers has been revealed as one of the most sound for that purpose&#46; Recent data show that remote hemodynamic-guided care&#44; tracking left atrial pressure&#44; pulmonary artery pressure or right ventricular pressures as estimates of filling pressures is undoubtedly beneficial in preventing HF hospitalizations&#44;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">7</span></a> validating the robustness and apparent superiority of the predictive value of these parameters&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">8</span></a> Of these&#44; sensing pulmonary artery pressure by CardioMEMS HF System &#40;Abbott&#44; Sylmar&#44; California&#41; seems to outperform other options having one of the most solid pieces of evidence in reducing HF hospitalizations&#44; with a remarkable more than 50&#37; drop&#44; regardless of HF phenotype &#40;either with a reduced or a preserved ejection fraction&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">9</span></a> Wearable devices&#44; defined as externally applied gadgets capable of sensing functional and physiological signals&#44; are newcomers to the HF arena as non-invasive alternatives to such technologies&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">In this issue of the <span class="elsevierStyleItalic">Journal</span>&#44; Martins et al&#46; present the rationale behind a proposed prototype of a wearable vest with an inbuilt multisensory system&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">10</span></a> In brief&#44; the authors integrate this device in a broader project of remote HF monitoring they intend to implement &#8211; the GENICA project&#46; Is this unprecedented&#63; Despite being an emerging approach&#44; they are not pioneers in this field&#46; As others have done previously&#44; they hypothesized that ambulatory non-invasive device-based capture&#44; collection&#44; transference&#44; and processing of biodata might be of value in HF care&#46; The efficacy of this non-invasive biodata streaming has not yet been entirely determined&#44; and the evidence in this setting is scarce&#46; Preliminary strategies using single-channel monitoring&#44; based on transthoracic bioimpedance obtained via a wearable vest&#44; have shown encouraging results&#46; The SENTINEL-HF trial reported 87&#37; sensitivity and 70&#37; specificity for identifying recurrent HF events&#44; the downside being significant data loss and patient withdrawal&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">11</span></a> Estimation of lung fluid content by dielectric sensing is another alternative under investigation&#46; Amir et al&#46;&#44; using remote dielectric sensing technology &#40;ReDS&#41;&#44; reported&#44; in an observational&#44; multicenter&#44; prospective study of 50 patients&#44; an 87&#37; reduction and a 79&#37; increase in hospitalization with ReDS-guided medical titration when compared&#44; respectively&#44; to the 90 days prior and the 90 days post-use of the vest&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">12</span></a> A prospective randomized clinical trial using this device in acute HF hospitalized patients is underway &#40;NCT03586336&#41;&#46; An analogous device&#44; targeting lung-fluid evaluation&#44; albeit with additional functionalities&#44; is being tested in a larger-scale clinical trial &#40;NCT03476187&#41; and will&#44; hopefully&#44; shed further light on this topic&#46; Furthermore&#44; novel metrics to assess cardiovascular hemodynamics and impending HF decompensation are emerging&#44; such as evaluation of seismocardiogram signals that rely on chest vibrations and leg bioimpedance measurements&#46;<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">13&#44;14</span></a> Nevertheless&#44; despite the heightened interest in these wearable vests&#44; there are no data on their real-world impact on HF hospitalizations&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The current trend on the toolbox of wearables in HF focuses on multiparameter systems&#46; The authors&#8217; proposal is part of this recent trend and has the potential to bring additional insights into this field&#46; The precursor MUSIC study comprised an external&#44; adherent&#44; multisensor system that had&#44; in the validation cohort&#44; 63&#37; sensitivity and 92&#37; specificity for detection of HF events&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">15</span></a> Recently&#44; Stehlik et al&#46; described the results of a wearable device similar to the authors&#44; also integrating a variety of sensors &#40;ECG&#44; heart rate&#44; respiratory rate&#44; body temperature&#44; activity level&#44; and body position&#41;&#44; tested in the LINK-HF study &#40;Multisensor Non-invasive Remote Monitoring for Prediction of Heart Failure Exacerbation&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">16</span></a> Using a machine learning algorithm&#44; the analytical platform tested demonstrated 76&#37; to 88&#37; sensitivity and an 85&#37; specificity to detect precursors of HF hospitalizations with median anticipation &#40;time from alert to readmission&#41; of 6&#46;5 days&#46; These results compare closely to those of implantable devices&#46; Likewise&#44; just a few months ago&#44; another analogous cloth-based diagnostic monitoring platform &#40;Wearable Congestive Heart Failure Management System - SimpleSENSE&#41; received FDA approval&#46; Its application in HF care is being tested in the validation NanoSENSE trial &#40;<span class="elsevierStyleItalic">NCT03719079</span>&#41;&#46; The device designed by the authors integrates a sizable number of biosensors targeting vital&#44; electrophysiological&#44; hemodynamic&#44; and chemical biosignals&#58; transthoracic impedance&#44; electrocardiographic data &#40;heart rate and heart rate variability&#44; T wave amplitude variability&#44; electric conduction abnormalities&#44; atrial and ventricular arrhythmias&#44; myocardial ischemia&#41;&#44; right atrial and left atrial pressures&#44; systemic arterial blood pressure&#44; pre-ejection period&#44; cardiac output&#44; peripheral oxygen saturation&#44; respiratory rate&#44; and skin sodium content&#44; along with patient&#39;s physical activity levels&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">In this paper&#44; the investigators explore the theoretical foundations for selecting these specific bioparameters&#46; Most of them are self-evident options&#44; whereas others are of questionable interest&#46; The complex interplay of pre-ejection period determinants alongside the redundant information it provides compared to other signals impairs its incremental diagnostic value with the disadvantage of adding intricacy to the analytical system&#46; The skin has increasingly been recognized to participate in the regulatory system of body sodium &#40;Na&#41; homeostasis&#46; Skin Na-storage role&#44; better studied in other conditions such as hypertension and chronic renal disease&#44; has little evidence in HF&#44; as acknowledged by the authors&#46; Hence&#44; the inclusion of a Na-sensor has the single merit of functioning as a research tool rather than an intervention-guiding parameter&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">One of the main difficulties that this prototype may encounter is feasibility&#46; Technical operability&#44; although challenging considering the number of sensors required&#44; is probably the easiest to circumvent&#46; The assembling of the enormous dataflow volume that such a system will generate is the ultimate challenge the authors face&#44; along with mapping out well-defined downstream healthcare delivery models to attain this approach&#39;s full potential&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">This device&#44; similar to others&#44; offers the possibility of reshaping the monitoring paradigm of HF ambulatory care&#46; However&#44; some caution is wise before becoming overenthusiastic&#46; Several obstacles&#44; beyond the technological ones&#44; must be overcome&#46; We are at a point in engineering informatics where remote collection and processing of data pose little difficulties&#44; and the level of precision is high&#46; Data overload is a concern&#44; but several upfront technical solutions integrating artificial intelligence-driven algorithms are already in place or on the horizon&#46; Contrarily&#44; most of the medical infrastructures and healthcare modus operandi face some inertia and are now surpassed by these technological innovations&#46; So&#44; converting those data into better clinical decision-making impacting HF outcomes is the actual task that the medical community has to handle&#46; Successful implementation of these interventions is dependent not only on appropriate patient selection and widespread availability&#44; but also on the effectiveness of the network of logistics and operationality set&#46; The inconsistent application of cardiac implantable electronic devices monitoring capabilities in HF care&#44; tracking almost the same biosignals as wearables&#44; clearly demonstrates this&#46; Lastly&#44; there are legal and ethical issues related to regulation and data security that have to be addressed&#46; In Europe&#44; strict regulatory systems require conformity with the CE marking &#40;EU Regulations 2017&#47;745 and 2020&#47;561&#41; and General Data Processing Regulation &#40;GDPR - EU Regulation 2016&#47;679&#41;&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">All things considered&#44; given modern HF care needs&#44; once proven valid and reliable&#44; it is foreseeable that these innovative wearable solutions will assuredly be well-received&#46; It is expected that their application will be efficacious&#44; provided they do not jeopardize intangibles variables such as quality-of-life and well-being&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">For the time being&#44; we are at the outset of this new frontier in HF management&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0050" class="elsevierStylePara elsevierViewall">The author has no conflicts of interest to declare&#46;</p></span></span>"
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            0 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "1"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "EURObservational Research Programme&#58; regional differences and 1-year follow-up results of the Heart Failure Pilot Survey &#40;ESC-HF Pilot&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "A&#46;P&#46; Maggioni"
                            1 => "U&#46; Dahlstr&#246;m"
                            2 => "G&#46; Filippatos"
                          ]
                        ]
                      ]
                    ]
                  ]
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                    0 => array:2 [
                      "doi" => "10.1093/eurjhf/hft050"
                      "Revista" => array:7 [
                        "tituloSerie" => "Eur J Heart Fail"
                        "fecha" => "2013"
                        "volumen" => "15"
                        "paginaInicial" => "808"
                        "paginaFinal" => "817"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23537547"
                            "web" => "Medline"
                          ]
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                          "pii" => "S1470204513700937"
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            1 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical phenotypes and outcome of patients hospitalized for acute heart failure&#58; the ESC Heart Failure Long-Term Registry"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "O&#46; Chioncel"
                            1 => "A&#46; Mebazaa"
                            2 => "V&#46;P&#46; Harjola"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/ejhf.890"
                      "Revista" => array:7 [
                        "tituloSerie" => "Eur J Heart Fail"
                        "fecha" => "2017"
                        "volumen" => "19"
                        "paginaInicial" => "1242"
                        "paginaFinal" => "1254"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28463462"
                            "web" => "Medline"
                          ]
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                          "pii" => "S1470204513704649"
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              ]
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            2 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Current costs of heart failure in Portugal and expected increases due to population aging"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46;R&#46;A&#46; Gouveia"
                            1 => "R&#46; Ascen&#231;&#227;o"
                            2 => "F&#46; Fiorentino"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.repc.2019.09.006"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Port Cardiol"
                        "fecha" => "2020"
                        "volumen" => "39"
                        "paginaInicial" => "3"
                        "paginaFinal" => "11"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31973946"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Implant-based multiparameter telemonitoring of patients with heart failure &#40;IN-TIME&#41;&#58; a randomised controlled trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "G&#46; Hindricks"
                            1 => "M&#46; Taborsky"
                            2 => "M&#46; Glikson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(14)61176-4"
                      "Revista" => array:7 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2014"
                        "volumen" => "384"
                        "paginaInicial" => "583"
                        "paginaFinal" => "590"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25131977"
                            "web" => "Medline"
                          ]
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                          "pii" => "S1470204518307782"
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                          "issn" => "14702045"
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                ]
              ]
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            4 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A multisensor algorithm predicts heart failure events in patients with implanted devices&#58; results from the MultiSENSE study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46;P&#46; Boehmer"
                            1 => "R&#46; Hariharan"
                            2 => "F&#46;G&#46; Devecchi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jchf.2016.12.011"
                      "Revista" => array:6 [
                        "tituloSerie" => "JACC Heart Fail"
                        "fecha" => "2017"
                        "volumen" => "5"
                        "paginaInicial" => "216"
                        "paginaFinal" => "225"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28254128"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Remote management of heart failure using implantable electronic devices"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46;M&#46; Morgan"
                            1 => "S&#46; Kitt"
                            2 => "J&#46; Gill"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/eurheartj/ehx227"
                      "Revista" => array:7 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2017"
                        "volumen" => "38"
                        "paginaInicial" => "2352"
                        "paginaFinal" => "2360"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28575235"
                            "web" => "Medline"
                          ]
                        ]
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                          "pii" => "S0302283817302774"
                          "estado" => "S300"
                          "issn" => "03022838"
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                  ]
                ]
              ]
            ]
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              "identificador" => "bib0115"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Remote haemodynamic-guided care for patients with chronic heart failure&#58; a meta-analysis of completed trials"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "P&#46;B&#46; Adamson"
                            1 => "G&#46; Ginn"
                            2 => "S&#46;D&#46; Anker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/ejhf.638"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Heart Fail"
                        "fecha" => "2017"
                        "volumen" => "19"
                        "paginaInicial" => "426"
                        "paginaFinal" => "433"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27634736"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Device monitoring in heart failure management&#58; outcomes based on a systematic review and meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Halawa"
                            1 => "T&#46; Enezate"
                            2 => "G&#46; Flaker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.21037/cdt.2019.01.02"
                      "Revista" => array:6 [
                        "tituloSerie" => "Cardiovasc Diagn Ther"
                        "fecha" => "2019"
                        "volumen" => "9"
                        "paginaInicial" => "386"
                        "paginaFinal" => "393"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31555544"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lower rates of heart failure and all-cause hospitalizations during pulmonary artery pressure-guided therapy for ambulatory heart failure&#58; one-year outcomes from the CardioMEMS post-approval study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "D&#46;M&#46; Shavelle"
                            1 => "A&#46;S&#46; Desai"
                            2 => "W&#46;T&#46; Abraham"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCHEARTFAILURE.119.006863"
                      "Revista" => array:5 [
                        "tituloSerie" => "Circ Heart Fail"
                        "fecha" => "2020"
                        "volumen" => "13"
                        "paginaInicial" => "e006863"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32757642"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "MONITORIA&#58; starting a new era of ambulatory heart failure monitoring&#63; Part I &#8211; theoretical rationale"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "C&#46; Martins"
                            1 => "J&#46; Machado da Silva"
                            2 => "D&#46; Guimar&#227;es"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:3 [
                        "tituloSerie" => "Rev Port Cardiol"
                        "fecha" => "2021"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2631811"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bioimpedance-based heart failure deterioration prediction using a prototype fluid accumulation vest-mobile phone dyad&#58; an observational study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "C&#46;E&#46; Darling"
                            1 => "S&#46; Dovancescu"
                            2 => "J&#46;S&#46; Saczynski"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2196/cardio.6057"
                      "Revista" => array:5 [
                        "tituloSerie" => "JMIR Cardio"
                        "fecha" => "2017"
                        "volumen" => "1"
                        "paginaInicial" => "e1"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31758769"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluation of remote dielectric sensing &#40;ReDS&#41; technology-guided therapy for decreasing heart failure re-hospitalizations"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "O&#46; Amir"
                            1 => "T&#46; Ben-Gal"
                            2 => "J&#46;M&#46; Weinstein"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ijcard.2017.02.120"
                      "Revista" => array:7 [
                        "tituloSerie" => "Int J Cardiol"
                        "fecha" => "2017"
                        "volumen" => "240"
                        "paginaInicial" => "279"
                        "paginaFinal" => "284"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28341372"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0140673619307238"
                          "estado" => "S300"
                          "issn" => "01406736"
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                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Novel wearable seismocardiography and machine learning algorithms can assess clinical status of heart failure patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "O&#46;T&#46; Inan"
                            1 => "M&#46; Baran Pouyan"
                            2 => "A&#46;Q&#46; Javaid"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCHEARTFAILURE.117.004313"
                      "Revista" => array:5 [
                        "tituloSerie" => "Circ Heart Fail"
                        "fecha" => "2018"
                        "volumen" => "11"
                        "paginaInicial" => "e004313"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29330154"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bioimpedance and new-onset heart failure&#58; a longitudinal study of &#62;500 000 individuals from the general population"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "D&#46; Lindholm"
                            1 => "E&#46; Fukaya"
                            2 => "N&#46;J&#46; Leeper"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/JAHA.120.020143"
                      "Revista" => array:4 [
                        "tituloSerie" => "J Am Heart Assoc"
                        "fecha" => "2018"
                        "volumen" => "7&#46;"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33904317"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Design and performance of a multisensor heart failure monitoring algorithm&#58; results from the multisensor monitoring in congestive heart failure &#40;MUSIC&#41; study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "I&#46;S&#46; Anand"
                            1 => "W&#46;H&#46; Tang"
                            2 => "B&#46;H&#46; Greenberg"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.cardfail.2012.01.009"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Card Fail"
                        "fecha" => "2012"
                        "volumen" => "18"
                        "paginaInicial" => "289"
                        "paginaFinal" => "295"
                        "link" => array:1 [
                          0 => array:2 [
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ISSN: 08702551
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