The new universal definition of HF published earlier this year underscores congestion as a pathophysiological syndrome playing a leading role in the evolution and progression of HF. However, in terms of HF as a disease state, we recognize the role of congestion as a driving force in both HFpEF and HFrEF. But almost all guideline-directed medical management is for HFrEF and not HFpEF. This is important because we traditionally divide HF into reduced and preserved EF. The present analysis confirms what was known from the CHAMPION trial, which created the evidence base for utilization of this technology: Hemodynamic monitoring reduces hospitalizations in all HF, regardless of EF. It may also translate to improved quantity of life, but we do not yet have evidence of this. The reduction is quite substantial and translates to better quality of life, which is improved by avoidance of hospitalizations.
VOLUMETRIX MEDICAL TRIAL
The trial proved what we knew already: If we hemodynamically monitor ambulatory patients with HF, and tailor our strategy by hemodynamic data, it improves outcomes and patients are not admitted with HF as frequently as before. What GUIDE-HF shows us in both groups is that we can apply hemodynamic-guided management earlier in the course of disease: in class II patients and in those patients who have not yet had a hospitalization but just have elevated natriuretic peptides.” “Hemodynamic-guided management of heart failure is one of a very small number of effective therapies in HFpEF patients. Both primary and heart failure event rates were lower in HFpEF than in HFrEF, as in previous studies, but the relative benefit of hemodynamic-guided management was similar in both, consistent with previous studies,” Lindenfeld said at the press conference. “The GUIDE-HF patients were similar to those in previous trials of hemodynamic monitoring. She noted patients with HFpEF had improved outcomes in the CardioMEMS group compared with the control group regardless of whether HFpEF was defined as EF 50% or more or EF more than 40%. 051), she said, noting that absolute event rates were less in HFpEF than in HFrEF. Total HF events were reduced in the CardioMEMS group compared with the control group regardless of whether patients had HFpEF (HR = 0.72 95% CI, 0.48-1.07 P =. “The trial was not powered to create a subgroup difference.” “Neither of these groups were quite statistically significant, but remember, these are subgroups,” she said. 2), Lindenfeld said at the press conference. 07) or HF with reduced ejection fraction, defined as less than 50% (HR = 0.85 95% CI, 0.66-1.09 P =. In the pre-COVID-19 analysis, the primary endpoint of mortality and total HF events occurred less often in those who had the CardioMEMS device activated compared with controls regardless of whether they had HF with preserved ejection fraction, defined as 50% or more (HR = 0.7 95% CI, 0.47-1.03 P =. The trial included 1,000 patients with NYHA Class II, III or IV HF and elevated natriuretic peptide levels or at least one HF hospitalization in the prior year. Riven Director in Cardiology at Vanderbilt University Medical Center, said during a press conference. “Elevated or increasing pulmonary artery pressures are associated with higher heart failure hospitalization rates and higher mortality,” Cardiology Today Editorial Board Member JoAnn Lindenfeld, MD, professor of medicine and Samuel S.
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