Work

Relationship Between Ambulatory Pulmonary Artery Pressures and Heart Failure Hospitalizations in Patients With Chronic Heart Failure

Year: 2026

Type: article

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.

Source: JACC Heart Failure

DOI: 10.1016/j.jchf.2026.103239