Effects of remote haemodynamic‐guided heart failure management in patients with different subtypes of pulmonary hypertension: insights from the MEMS‐HF study

• Published in: European journal of heart failure 2022-12, Vol.24 (12), p.2320-2330
• Main Authors: Assmus, Birgit, Angermann, Christiane E., Alkhlout, Basil, Asselbergs, Folkert W., Schnupp, Steffen, Brugts, Jasper J., Nordbeck, Peter, Zhou, Qian, Brett, Marie‐Elena, Ginn, Greg, Adamson, Philip B., Böhm, Michael, Rosenkranz, Stephan
• Format: Article
• Language: English
• Subjects: Heart failure; Heart Failure - diagnosis; Hemodynamics; Hospitalization; Humans; Hypertension, Pulmonary - therapy; Micro-Electrical-Mechanical Systems; Pulmonary artery pressure; Pulmonary hypertension; Quality of Life; Remote monitoring
• ISSN: 1388-9842; 1879-0844
• DOI: 10.1002/ejhf.2656

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