Management of the Patient with Heart Failure and an Implantable Pulmonary Artery Hemodynamic Sensor
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TECHNOLOGY AND CARDIOVASCULAR HEALTH (E. MUSE, SECTION EDITOR)
Management of the Patient with Heart Failure and an Implantable Pulmonary Artery Hemodynamic Sensor Jacob Abraham 1 & Patrick J. McCann 2 & Maya E. Guglin 3 & Arvind Bhimaraj 4 & Terrie-Ann S. Benjamin 5 & Monique R. Robinson 6 & Orvar T. Jonsson 7 & Scott C. Feitell 8 & Kunjan A. Bhatt 9 & Mosi K. Bennett 10 & J.T. Heywood 11 & on behalf of Hemodynamic Frontiers in Heart Failure (HF2) Investigators Published online: 14 July 2020 # The Author(s) 2020
Abstract Purpose of Review Heart failure (HF) management guided by hemodynamics obtained from an implantable pulmonary artery pressure (PAP) sensor (CardioMEMS) improves symptoms and reduces HF hospitalizations (HFH). This paper reviews the theoretical basis of pulmonary vascular physiology, summarizes recently published data about CardioMEMS, and provides practical guidelines for patient selection and management. Recent Findings Compared to patients managed by standard care, HF patients randomized to PAP-guided treatment have a higher frequency of medication adjustments, resulting in lower PAP and fewer HFH. Real-world analyses further support associations between implant of the CardioMEMS sensor with reductions in PAP, hospitalizations, and mortality. Summary Implantable, wireless hemodynamic sensor technology is a promising remote monitoring platform for chronic HF. A phased approach using a treatment algorithm may improve the efficiency and effectiveness of pressure-guided therapy. Keywords Pulmonary artery . Pulmonary hypertension . Heart failure . Hemodynamics . Remote monitoring
Abbreviations ACE-I ARB APP BMI BPM
CHAMPION Angiotensin-converting-enzyme inhibitor Angiotensin receptor blocker Advanced practice provider Body mass index Beats per minute
CI CpcPH
CardioMEMS Heart Sensor Allows Monitoring of Pressure to Improve Outcomes in NYHA Class III Heart Failure Patients Confidence interval Combined pre-capillary and post-capillary pulmonary hypertension
This article is part of the Topical Collection on Technology and Cardiovascular Health * Jacob Abraham [email protected] Patrick J. McCann [email protected] Maya E. Guglin [email protected] Arvind Bhimaraj [email protected] Monique R. Robinson [email protected]
Orvar T. Jonsson [email protected] Scott C. Feitell [email protected] Kunjan A. Bhatt [email protected] Mosi K. Bennett [email protected] J.T. Heywood [email protected] Extended author information available on the last page of the article
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DPG DSRC EF GFR GUIDE-HF HF HFH HFpEF HFrEF HR IV LA LVAD NT-proBNP NYHA PA PAP PADP PCWP PVR PH PVR RV SGLT2 WU
Curr Cardiovasc Risk Rep (2020) 14: 12
Diastolic pressure gradient Device-related or system-related complications Ejection fraction Glomerular filtration rate Hemodynamic-GUIDEd Management of Heart Failure Heart failure Heart failure hospitalization Heart failure with preserved ejection fraction Heart fai
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