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Home-based telemonitoring care and executive function in patients with heart failure

Hypertension Research volume 48, pages 1919–1928 (2025)Cite this article

A Comment to this article was published on 12 June 2025

Abstract

Enhancement of self-care ability is essential for patients with heart failure (HF), and executive function plays a critical role. We investigated the clinical influence of a home-based remote care program using telemonitoring and telecoaching on executive function in patients with HF and assessed the relationship between executive functional status and clinical outcomes. This prospective study enrolled outpatients with HF, and they received home-based remote care program with telemonitoring and telecoaching using self-measured physical data. Executive function was assessed using the Trail Making Test Part B (TMT-B). The incidences of HF hospitalization and all-cause death were also compared according to baseline executive function status based on TMT-B test performance. Forty-one participants were enrolled in this study (mean age: 64.8 ± 13.8 years; male 68.3%; New York Heart Association [NYHA] class II/III: 78.0/22.0%). Twelve months after the initiation of the program, TMT-B significantly improved (p = 0.039), accompanied by an obvious amelioration of HF symptoms as assessed by the NYHA class (p = 0.027). During a median follow-up of 20.5 months, the incidence of HF hospitalization was significantly higher in patients with executive dysfunction than in those without (hazard ratio: 4.97, 95% confidence interval: 1.15–21.4, p = 0.031). This was unchanged even in a subcohort without cognitive dysfunction, as assessed using the Mini-Mental State Examination. Telemonitoring and telecoaching at home may be effective in improving executive function in patients with HF. Further studies are needed to assess whether supportive care assisting executive functioning improves clinical outcomes in patients with HF.

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Acknowledgements

We are grateful to Nurse Ms. Youko Itoyama for her dedicated contribution to the study (monitoring and consultation with clinicians). We thank the patients and medical staff who participated in this study. This study was supported in part by The Nakatomi Foundation.

Author information

Authors and Affiliations

  1. Department of Cardiovascular Medicine, Saga University, Saga, Japan

    Tetsuya Kaneko, Atsushi Tanaka, Hiroshi Hongo, Yoshiko Sakamoto, Ayumu Yajima & Koichi Node

  2. Clinical Research Center, Saga University Hospital, Saga, Japan

    Ayako Takamori

  3. Budounoki Clinic, Saga, Japan

    Machiko Asaka & Norihiko Kotooka

  4. Department of Cardiovascular Medicine, Saga-Ken Medical Centre Koseikan, Saga, Japan

    Tsuneki Ajimi & Kohei Kamishita

  5. Department of Cardiology, Ureshino Medical Center, Ureshino, Japan

    Yohei Inoue

  6. Division of Cardiology, Cardiovascular and Aortic Center, Saiseikai Fukuoka General Hospital, Fukuoka, Japan

    Daisuke Nagatomo

  7. Department of Cardiovascular Medicine, Saiseikai Karatsu Hospital, Karatsu, Japan

    Daisuke Fujimatsu

Authors
  1. Tetsuya Kaneko
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Contributions

Conceptualization: TK, ATanaka, NK, and KN; Methodology: TK, NK, and KN; Investigation: TK, HH, YS, AY, MA, TA, KK, YI, DN, DF, and NK; Analysis: TK and ATakamori; Supervision: ATanaka and KN; Writing–original draft: TK; Writing–review and editing: ATanaka, ATakamori, HH, YS, AY, MA, TA, KK, YI, DN, DF, NK, and KN.

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Correspondence to Atsushi Tanaka or Koichi Node.

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Kaneko, T., Tanaka, A., Takamori, A. et al. Home-based telemonitoring care and executive function in patients with heart failure. Hypertens Res 48, 1919–1928 (2025). https://doi.org/10.1038/s41440-025-02199-8

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