Use of a pulmonary artery pressure sensor to manage patients with left ventricular assist devices

Authors

Vinay Thohan, Mission Heart HCA HealthCare, Asheville, NC.
Jacob Abraham, Center for Cardiovascular Analytics, Research, and Data Science, Providence St. Vincent Medical Center, Portland, OR.
Adam Burdorf, University of Nebraska Medical Center, Omaha, NE.
Nasir Sulemanjee, Advocate Aurora HealthFollow
Brian Jaski, San Diego Cardiac Center, San Diego, CA.
Maya Guglin, Indiana University School of Medicine, Krannert Institute of Cardiology, Indianapolis, IN.
Francis D. Pagani, University of Michigan, Ann Arbor, MI.
Himabindu Vidula, University of Rochester Medical Center, Rochester, NY.
David T. Majure, Weill Cornell Medicine, Division of Cardiology, New York, NY.
Rebecca Napier, Prisma Health, Columbia, SC.
Thomas J. Heywood, Scripps Health, La Jolla, CA.
Rebecca Cogswell, University of Minnesota, Department of Medicine, Division of Cardiology, Minneapolis, MN.
Nicholas Dirckx, Abbott, Inc, Abbott Park, IL.
David J. Farrar, Abbott, Inc, Abbott Park, IL.
Stavros G. Drakos, University of Utah Health, Salt Lake City, UT.

Recommended Citation

Thohan V, Abraham J, Burdorf A, et al. Use of a Pulmonary Artery Pressure Sensor to Manage Patients With Left Ventricular Assist Devices. Circ Heart Fail. 2023;16(6):e009960. doi:10.1161/CIRCHEARTFAILURE.122.009960

Affiliations

St. Luke's Medical Center

Abstract

Background: Hemodynamic-guided management with a pulmonary artery pressure (PAP) sensor (CardioMEMS^TM) is effective in reducing heart failure hospitalization (HFH) in patients with chronic heart failure (HF). This study aims to determine the feasibility and clinical utility of the CardioMEMS HF system to manage patients supported with LVADs. Methods: In this multi-center prospective study, we followed patients with HeartMate II^TM (n=52) or HeartMate 3^TM (n=49) LVADs and with CardioMEMS PA Sensors, and measured PAP, 6-minute walk distance (6MWD), quality of life (EQ-5D-5L scores), and HFH rates through 6 months. Patients were stratified as responders (R) and non-responders (NR) to reductions in PA diastolic pressure (PAD). Results: There were significant reductions in PAD from baseline to 6 months in R (21.5 to 16.5 mmHg, pConclusions: LVAD patients managed with CardioMEMS with a significant reduction in PAD at 6 months showed improvements in 6MWD. Maintaining PAD < 20 mmHg was associated with fewer HF hospitalizations. Hemodynamic-guided management of LVAD patients with CardioMEMS is feasible and may result in functional and clinical benefits. Prospective evaluation of ambulatory hemodynamic management in LVAD patients is warranted. Registration: URL: https://clinicaltrials.gov Unique Identifier: NCT03247829.

Type

Article

PubMed ID

37079511