{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T07:27:19Z","timestamp":1772177239956,"version":"3.50.1"},"reference-count":16,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,12,7]]},"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Patients with chronic heart failure (CHF) can benefit from exercise rehabilitation (ER) with significant improvements in exercise capacity, quality of life and reduction in hospitalisations. Despite its reported benefits, only a small number of patients with CHF attend ER due to poor adherence, and improper exercise may even lead to adverse events. Remote ECG monitoring system (REMS) has the potential to overcome these obstacles. We hypothesise that home-based cardiac ER using REMS in CHF patients is effective compared with conventional ER without monitoring.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and analysis<\/jats:title>\n                  <jats:p>This study is a prospective, randomised, parallel controlled clinical trial designed to evaluate the effectiveness of home-based phase-II ER with REMS in the treatment of CHF with a target enrolment of 120 patients (left ventricular ejection fraction &lt;50%, New York Heart Association (NYHA) classes I to III). Patients are randomised to either REMS rehabilitation group or conventional rehabilitation group in a 1:1 ratio. All patients start an exercise training in a supervised setting and then transition to a home-based regimen. The supervised training phase consists of 12 supervised training sessions, three sessions per week for 4 weeks. During the home exercise phase, patients exercise five times per week for 8 weeks. In the REMS group, patients wear monitors during exercise to ensure that exercise intensity is within the set ranges. REMS will also detect risky arrhythmia and alert the patients and their doctors on time. The training intensity is not monitored in the conventional rehabilitation group. The primary outcome is exercise capacity improvement measured by peak oxygen uptake (VO<jats:sub>2<\/jats:sub> peak) (baseline vs 3\u2009m). Secondary outcomes include 6-min walk test, NYHA classes, echocardiographic parameters, cardiac biomarkers, major adverse cardiovascular events, quality of life, psychological well-being and patients\u2019 adherence to the rehabilitation programme.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Ethics and dissemination<\/jats:title>\n                  <jats:p>This study was approved by Ethics Committee of China-Japan Friendship Hospital for Clinical Research (No. 2018\u201355\u2009K39). The results of this study will be disseminated via peer-reviewed publications and presentations at conferences.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>ChiCTR-RNR-17012446; Pre-results.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2018-023923","type":"journal-article","created":{"date-parts":[[2019,3,6]],"date-time":"2019-03-06T05:48:07Z","timestamp":1551851287000},"page":"e023923","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["Effects of home-based cardiac exercise rehabilitation with remote electrocardiogram monitoring in patients with chronic heart failure: a study protocol for a randomised controlled trial"],"prefix":"10.1136","volume":"9","author":[{"given":"Jiahui","family":"Li","sequence":"first","affiliation":[{"name":"Department of Cardiology, China-Japan Friendship Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peng","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Integrative Cardiology, China-Japan Friendship Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dongliang","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Integrative Cardiology, China-Japan Friendship Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaojun","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Cardiology, China-Japan Friendship Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lifang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, China-Japan Friendship Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, China-Japan Friendship Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yiyun","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, China-Japan Friendship Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"He","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, China-Japan Friendship Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Chen","sequence":"additional","affiliation":[{"name":"Phase I Clinical Ward of Clinical Trial Research Center, China-Japan Friendship Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mingjing","family":"Shao","sequence":"additional","affiliation":[{"name":"Department of Integrative Cardiology, China-Japan Friendship Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chunyan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Integrative Cardiology, China-Japan Friendship Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Integrative Cardiology, China-Japan Friendship Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Cardiology, China-Japan Friendship Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Integrative Cardiology, China-Japan Friendship Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xianlun","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cardiology, China-Japan Friendship Hospital, Beijing, China"},{"name":"Department of Integrative Cardiology, China-Japan Friendship Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,3,5]]},"reference":[{"key":"2025101814520212000_9.3.e023923.1","first-page":"1076","article-title":"Editorial Board of Chinese Journal of Cardiology. Guidelines for the diagnosis and management of chronic heart failure","volume":"35","author":"Chinese Society of Cardiology of Chinese Medical Association","year":"2007","journal-title":"Zhonghua Xin Xue Guan Bing Za Zhi"},{"key":"2025101814520212000_9.3.e023923.2","first-page":"1","article-title":"Hu SS Representative group of Chinese cardiovascular diseases report. Report on cardiovascular diseases in China (2017)","volume":"33","author":"Chen","year":"2018","journal-title":"Chinese Circulation Journal"},{"key":"2025101814520212000_9.3.e023923.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.05.019"},{"key":"2025101814520212000_9.3.e023923.4","first-page":"98","article-title":"Editorial Board of Chinese Journal of Cardiology. Chinese guidelines for the diagnosis and treatment of heart failure 2014","volume":"42","author":"Chinese Society of Cardiology of Chinese Medical Association","year":"2014","journal-title":"Zhonghua Xin Xue Guan Bing Za Zhi"},{"key":"2025101814520212000_9.3.e023923.5","first-page":"714","article-title":"Committee of Cardio-Cerebral-Vascular Diseases of GSC. Chinese expert consensus on cardiac rehabilitation for patients with chronic stable heart failure","volume":"42","author":"Chinese Rehabilitation Medical Association Professional Committee of Cardiovascular Diseases","year":"2014","journal-title":"Zhonghua Xin Xue Guan Bing Za Zhi"},{"key":"2025101814520212000_9.3.e023923.6","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.592"},{"key":"2025101814520212000_9.3.e023923.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2009.07.014"},{"key":"2025101814520212000_9.3.e023923.8","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1186\/s40798-017-0086-z","article-title":"The contribution of individual exercise training components to clinical outcomes in randomised controlled trials of cardiac rehabilitation: a systematic review and meta-regression","volume":"3","author":"Abell","year":"2017","journal-title":"Sports Med Open"},{"key":"2025101814520212000_9.3.e023923.9","doi-asserted-by":"publisher","DOI":"10.1177\/2047487313501093"},{"key":"2025101814520212000_9.3.e023923.10","doi-asserted-by":"publisher","DOI":"10.1589\/jpts.25.631"},{"key":"2025101814520212000_9.3.e023923.11","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0161268","article-title":"Smartphone-Based Cardiac Rehabilitation Program: Feasibility Study","volume":"11","author":"Chung","year":"2016","journal-title":"PLoS One"},{"key":"2025101814520212000_9.3.e023923.12","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.jphys.2017.02.017","article-title":"Home-based telerehabilitation is not inferior to a centre-based program in patients with chronic heart failure: a randomised trial","volume":"63","author":"Hwang","year":"2017","journal-title":"J Physiother"},{"issue":"Suppl D","key":"2025101814520212000_9.3.e023923.13","doi-asserted-by":"crossref","first-page":"D113","DOI":"10.1093\/eurheartj\/sux024","article-title":"The future of telemedicine for the management of heart failure patients: a Consensus Document of the Italian Association of Hospital Cardiologists (A.N.M.C.O), the Italian Society of Cardiology (S.I.C.) and the Italian Society for Telemedicine and eHealth (Digital S.I.T.)","volume":"19","author":"Di Lenarda","year":"2017","journal-title":"Eur Heart J Suppl"},{"key":"2025101814520212000_9.3.e023923.14","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)62160-6"},{"key":"2025101814520212000_9.3.e023923.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.11.050"},{"key":"2025101814520212000_9.3.e023923.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.08.1010"}],"updated-by":[{"DOI":"10.1136\/bmjopen-2018-023923corr1","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2020,7,28]],"date-time":"2020-07-28T00:00:00Z","timestamp":1595894400000}}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2018-023923","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T21:52:07Z","timestamp":1760824327000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2018-023923"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3]]},"references-count":16,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2019,3,5]]},"published-print":{"date-parts":[[2019,3]]}},"alternative-id":["10.1136\/bmjopen-2018-023923"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2018-023923","relation":{"correction":[{"id-type":"doi","id":"10.1136\/bmjopen-2018-023923corr1","asserted-by":"object"}]},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,3]]}}}