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Seated Pulmonary Artery Pressure Monitoring in Patients With Heart Failure: Results of the PROACTIVE-HF Trial.
JACC Heart Fail
November 2024
Advanced Heart Failure Comprehensive Care Center and Division of Cardiology, University of California-San Francisco, San Francisco, California, USA. Electronic address:
Article Synopsis
- * The study, called PROACTIVE-HF, assessed the safety and effectiveness of this monitoring method in 456 patients with chronic heart failure across various centers in the US and Europe.
- * Results showed a 6-month event rate of 0.15 hospitalizations or deaths per patient, far below the goal of 0.43, with a very high safety rate for the device.
Implantable Hemodynamic Monitors Improve Survival in Patients With Heart Failure and Reduced Ejection Fraction.
J Am Coll Cardiol
February 2024
Ohio State University, Wexner Medical Center, Columbus, Ohio, USA.
Background: Trials evaluating implantable hemodynamic monitors to manage patients with heart failure (HF) have shown reductions in HF hospitalizations but not mortality. Prior meta-analyses assessing mortality have been limited in construct because of an absence of patient-level data, short-term follow-up duration, and evaluation across the combined spectrum of ejection fractions.
Objectives: The purpose of this meta-analysis was to determine whether management with implantable hemodynamic monitors reduces mortality in patients with heart failure and reduced ejection fraction (HFrEF) and to confirm the effect of hemodynamic-monitoring guided management on HF hospitalization reduction reported in previous studies.
Hemodynamic-Guided Heart Failure Management in Patients With Either Prior HF Hospitalization or Elevated Natriuretic Peptides.
JACC Heart Fail
June 2023
Vanderbilt Heart and Vascular Institute, Nashville, Tennessee, USA.
Background: In patients with symptomatic heart failure (HF) and previous heart failure hospitalization (HFH), hemodynamic-guided HF management using a wireless pulmonary artery pressure (PAP) sensor reduces HFH, but it is unclear whether these benefits extend to patients who have not been recently hospitalized but remain at risk because of elevated natriuretic peptides (NPs).
Objectives: This study assessed the efficacy and safety of hemodynamic-guided HF management in patients with elevated NPs but no recent HFH.
Methods: In the GUIDE-HF (Hemodynamic-Guided Management of Heart Failure) trial, 1,000 patients with New York Heart Association (NYHA) functional class II to IV HF and either previous HFH or elevated NP levels were randomly assigned to hemodynamic-guided HF management or usual care.
Background: Hemodynamic-guided heart failure management is a superior strategy to prevent decompensation leading to hospitalization compared with traditional clinical methods. It remains unstudied if hemodynamic-guided care is effective across severities of comorbid renal insufficiency or if this strategy impacts renal function over time.
Methods: In the CardioMEMS US PAS (Post-Approval Study), heart failure hospitalizations were compared from 1 year before and after pulmonary artery sensor implantation in 1200 patients with New York Heart Association class III symptoms and a previous hospitalization.
Use of a Pulmonary Artery Pressure Sensor to Manage Patients With Left Ventricular Assist Devices.
Circ Heart Fail
June 2023
Division of Cardiovascular Medicine & Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah Health and School of Medicine, Salt Lake City (S.G.D.).
Article Synopsis
- A study examined the use of the CardioMEMS pulmonary artery pressure sensor to manage chronic heart failure patients with left ventricular assist devices (LVADs), aiming to reduce hospitalizations.
- The research involved 101 patients (52 with HeartMate II and 49 with HeartMate 3), tracking their pulmonary artery pressure, walking ability, quality of life, and hospitalization rates over six months.
- Results showed that patients who significantly lowered their pulmonary artery diastolic pressure had better walking distances and fewer hospitalizations, indicating that the CardioMEMS system can effectively improve health outcomes in LVAD patients.
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