Universität zu Köln

Assmus, Birgit, Angermann, Christiane E., Alkhlout, Basil, Asselbergs, Folkert W., Schnupp, Steffen, Brugts, Jasper J., Nordbeck, Peter ORCID: 0000-0002-2560-4068, Zhou, Qian, Brett, Marie-Elena, Ginn, Greg, Adamson, Philip B., Bohm, Michael and Rosenkranz, Stephan (2022). Effects of remote haemodynamic-guided heart failure management in patients with different subtypes of pulmonary hypertension: insights from the MEMS-HF study. Eur. J. Heart Fail., 24 (12). S. 2320 - 2331. HOBOKEN: WILEY. ISSN 1879-0844

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Abstract

Aim The CardioMEMS European Monitoring Study for Heart Failure (MEMS-HF) investigated safety and efficacy of pulmonary artery pressure (PAP)-guided remote patient management (RPM) in New York Heart Association (NYHA) class III outpatients with at least one heart failure hospitalization (HFH) during the previous 12 months. This pre-specified subgroup analysis investigated whether RPM effects depended on presence and subtype of pulmonary hypertension (PH). Methods and results In 106/234 MEMS-HF participants, Swan-Ganz catheter tracings obtained during sensor implant were available for off-line manual analysis jointly performed by two experts. Patients were classified into subgroups according to current PH definitions. Isolated post-capillary PH (IpcPH) and combined post- and pre-capillary PH (CpcPH) were present in 38 and 36 patients, respectively, whereas 31 patients had no PH. Clinical characteristics were comparable between subgroups, but among patients with PH pulmonary vascular resistance was higher (p = 0.029) and pulmonary artery compliance lower (p = 0.003) in patients with CpcPH. During 12 months of PAP-guided RPM, all PAPs declined in IpcPH and CpcPH subgroups (all p < 0.05), whereas only mean and diastolic PAP decreased in patients without PH (both p < 0.05). Improvements in post- versus pre-implant HFH rates were similar in CpcPH (0.639 events/patient-year; hazard ratio [HR] 0.37) and IpcPH (0.72 events/patient-year; HR 0.45) patients. Participants without PH benefited most (0.26 events/patient-year; HR 0.17, p = 0.04 vs. IpcPH/CpcPH patients). Quality of life and NYHA class improved significantly in all subgroups. Conclusions Outpatients with NYHA class III symptoms with at least one HFH during 1 year pre-implant benefitted significantly from PAP-guided RPM during post-implant follow-up irrespective of presence or subtype of PH at baseline.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Assmus, Birgit UNSPECIFIED UNSPECIFIED UNSPECIFIED Angermann, Christiane E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Alkhlout, Basil UNSPECIFIED UNSPECIFIED UNSPECIFIED Asselbergs, Folkert W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schnupp, Steffen UNSPECIFIED UNSPECIFIED UNSPECIFIED Brugts, Jasper J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Nordbeck, Peter UNSPECIFIED orcid.org/0000-0002-2560-4068 UNSPECIFIED Zhou, Qian UNSPECIFIED UNSPECIFIED UNSPECIFIED Brett, Marie-Elena UNSPECIFIED UNSPECIFIED UNSPECIFIED Ginn, Greg UNSPECIFIED UNSPECIFIED UNSPECIFIED Adamson, Philip B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bohm, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Rosenkranz, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-693402
DOI:	10.1002/ejhf.2656
Journal or Publication Title:	Eur. J. Heart Fail.
Volume:	24
Number:	12
Page Range:	S. 2320 - 2331
Date:	2022
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1879-0844
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PRESERVED EJECTION FRACTION; ARTERY PRESSURE Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/69340