The first investigator-initiated study focusing on remote pulmonary artery pressure monitoring has found a significant improvement in quality of life and a reduction in hospitalizations for patients with chronic heart failure.
The research was unveiled in a late-breaking science session at Heart Failure 2023, a scientific congress of the European Society of Cardiology (ESC), and published in The Lancet.
Pulmonary Artery Pressure as a Congestion Marker
“Pulmonary artery pressure is a marker of hemodynamic congestion, which occurs several weeks before symptoms develop,” says principal investigator Dr. Jasper Brugts of Erasmus University Medical Centre, Rotterdam, the Netherlands.
This early detection of congestion provides a window of opportunity for physicians to prevent overt congestion and subsequent hospitalization.
Prior Research and the Need for More Data
The value of pulmonary artery pressure monitoring has been debated due to uncertain results from two previous North American trials (CHAMPION and GUIDE-HF).
Despite positive results from the CHAMPION trial, the GUIDE-HF trial revealed neutral results, possibly due to a broader, lower-risk population or COVID-19 interference.
These inconclusive findings have led to limited uptake of the technique in Europe and a call for more data.
The MONITOR-HF Study
Responding to this need for more evidence, the MONITOR-HF study tested the impact of hemodynamic monitoring on quality of life and heart failure hospitalizations in a Netherlands population against the contemporary standard of care.
The study included 348 patients with chronic heart failure and other qualifying conditions from 25 centers in the Netherlands.
Patients were randomized 1:1 to either receive pulmonary artery pressure monitoring on top of usual care or usual care alone.
Patients in the monitoring group had a wireless sensor implanted into the pulmonary artery.
Daily pressure measurements were taken and sent to a secure website for physicians to review and adjust treatment as needed.
Findings and Implications
The primary outcome measure was the change in the quality of life after 12 months, and the secondary endpoint was the number of heart failure hospitalizations or urgent visits requiring intravenous diuretics during follow-up.
At 12 months, the average change in the quality of life score was significantly higher in the monitoring group (+7 points) than in the usual care group (-0.2 points).
Additionally, a 44% reduction in heart failure hospitalizations or urgent visits was observed in the monitoring group.
According to Dr. Brugts, the study showed that pulmonary artery pressure monitoring had a “substantial and significant effect on the quality of life and heart failure hospitalizations.”
He added that this approach ensures that physicians only need to respond to patients outside their threshold window, making it an efficient and time-effective method.
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The study was published in The Lancet.
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