Seated mean pulmonary artery pressure increased significantly from 27.8 mmHg at 60 days pre-event to 32.6 mmHg at the time of a heart failure event (p<0.001), with faster kinetics in LVEF>40%.
Cohort (n=456)
Does remote monitoring of seated pulmonary artery pressure and vital signs reveal predictive trends prior to heart failure events?
Seated mean pulmonary artery pressure increases weeks in advance of heart failure events, with a more rapid rise in patients with LVEF >40%, whereas vital signs do not change consistently.
valor p: p=<0.001
INTRODUCTION: Trends in upright seated pulmonary artery pressure (PAP) with synchronous measurement of weight, blood pressure (BP), and heart rate (HR) have not been compared prior to heart failure events (HFE) and other causes of hospitalization during remote monitoring. METHOD: We analyzed 24-month data from patients in PROACTIVE-HF trial. Participants (N=456) used the CordellaTM HF daily to measure seated PAP, weight, BP, and HR, all taken and transmitted within minutes. Events that were analyzed included HFE, those potentially related to HF treatment (HF-TRE) and others (non-HFE). Parameters were trended from 60-days before (D-60) to 30-days after (D+30) the day of event (D=0), and their concurrent changes were compared between D-60 and D=0, and D=0 and D+30 using mixed effects model. RESULTS: There were 196 HFE, 276 non-HFE and 66 HF-TRE. Prior to HFE, average mean PAP (mPAP) increased from 27.8±10.9mmHg at D-60 to 32.6±11.2mmHg at D=0 (p40%, whereas a similar magnitude (3.1±9.1mmHg) of mPAP rise occurred over 6-weeks before HFE in those with LVEF≤40%. No consistent changes in weight, SBP or HR prior to HFE were observed (p>0.05). Changes in vital signs but not mPAP were noted prior to HF-TRE and non-HFE. CONCLUSION: Seated mPAP increased weeks in advance of HFE and vital signs did not change consistently before HFE. Differential kinetics of mPAP prior to HFE by the LVEF suggest that an uptrend in seated mPAP may need to be addressed more rapidly in those with LVEF>40%. Changes in vital signs with non-HFE and HF-TRE need further validation.
Zalawadiya et al. (Thu,) conducted a cohort in Heart failure (n=456). Remote monitoring using Cordella HF system (seated PAP, weight, BP, HR) was evaluated on Changes in mean pulmonary artery pressure (mPAP) prior to heart failure events (D-60 to D=0) (p=<0.001). Seated mean pulmonary artery pressure increased significantly from 27.8 mmHg at 60 days pre-event to 32.6 mmHg at the time of a heart failure event (p<0.001), with faster kinetics in LVEF>40%.