Relationship between ambulatory pulmonary artery pressures and heart failure hospitalizations in patients with chronic heart failure

Authors

• Michael R. Zile, Medical University of South Carolina, RJH Department of Veterans Affairs Health Care System, Charleston, South Carolina, USA. Electronic address: zilem@musc.edu.
• William T. Abraham, Ohio State University, Wexner Medical Center, Columbus, Ohio, USA.
• Lynne W. Stevenson, Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
• Maria Rosa Costanzo, Advocate Health - MidwestFollow
• Christiane E. Angermann, Comprehensive Heart Failure Center, University and University Hospital, Würzburg, Germany; Department of Medicine I, University Hospital Würzburg, Würzburg, Germany.
• Mandeep R. Mehra, Center for Advanced Heart Disease, Brigham and Women's Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA.
• Akshay S. Desai, Center for Advanced Heart Disease, Brigham and Women's Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA.
• Anique Ducharme, Montreal Heart Institute, Université de Montréal, Montreal, Canada.
• Catalin F. Baicu, Medical University of South Carolina, RJH Department of Veterans Affairs Health Care System, Charleston, South Carolina, USA.
• Nessa Johnson, Abbott, Abbott Park, Illinois, USA.
• John Henderson, Abbott, Abbott Park, Illinois, USA.
• Carlo Gazzola, Abbott, Abbott Park, Illinois, USA.
• JoAnn Lindenfeld, Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Recommended Citation

Zile MR, Abraham WT, Stevenson LW, et al. Relationship Between Ambulatory Pulmonary Artery Pressures and Heart Failure Hospitalizations in Patients With Chronic Heart Failure. JACC Heart Fail. Published online July 31, 2026. doi:10.1016/j.jchf.2026.103239

Abstract

Background: Pulmonary artery pressure (PAP) monitors provide ambulatory hemodynamic assessment of patients with chronic heart failure (HF).

Objectives: The current analysis was designed to determine whether baseline systolic, diastolic, and mean PAPs and changes in PAPs from baseline to 6 months each were independent predictors of a heart failure hospitalization (HFH) within 2 years.

Methods: Retrospective analysis of CardioMEMS data from 4 studies including CHAMPION (CardioMEMS Heart Sensor Allows Monitoring of Pressure to Improve Outcomes) (n = 550), GUIDE-HF (Hemodynamic-GUIDEed Management of Heart Failure) (n = 2,358), US PAS (CardioMEMS HF System Post Approval Study) (n = 1,200), and MEMS-HF (CardioMEMS Monitoring Study for Heart Failure) (n = 234) included all enrolled patients regardless of treatment assignment (N = 4,342), reduced ejection fraction (<50%) (n = 2,562), and preserved ejection fraction (≥50%) (n = 1,454). Relationships between baseline pressure (averaged over 14 days after implantation) and change in pressure from baseline to 6 months (averaged over 14 days just before the 6-month time point) and HFH risk were evaluated over a 2-year follow-up.

Results: Baseline diastolic PAP was an independent predictor of HFH (HR: 1.043 [95% CI: 1.035-1.050]; P < 0.0001). Change in diastolic PAP (baseline to 6 months, assessed as a continuous variable) was an independent predictor of HFH (landmark analysis; HR: 1.047 [95% CI: 1.035-1.0506]; P < 0.0001). A decrease or increase of >2 mm Hg in diastolic PAP (baseline to 6 months, assessed as categorical variable) compared with no change predicted a 16.1% decrease and 50.1% increase in HFH (P < 0.0001). Results were comparable for systolic and mean PAPs and for patients with HF with reduced ejection fraction and HF with preserved ejection fraction.

Conclusions: Baseline PAP and change in PAP from baseline to 6 months (systolic, diastolic, and mean) were independent predictors of HFH within 2 years. Current and previous data from 4 studies using CardioMEMS indicate that PAP is an independent predictor of both mortality and HFH.

Document Type

Article

PubMed ID

42535981