Hemodynamic Monitoring for Heart Failure Patients

Academic Content

Program Overview

Faculty Presentations

Introduction Akshay S. Desai MD, MPH William T. Abraham, MD

Faculty Roundtable Discussion

Presentation Notes and References

Current Activity

William T Abraham, MD, FACP, FACC, FAHA, FESC
Director, Division of Cardiovascular Medicine
Professor of Internal Medicine, Physiology and Cell Biology
The Ohio State University Wexner Medical Center
Deputy Director, Davis Heart and Lung Research Institute
The Ohio State University
Columbus, Ohio

Fig. 01 -

Presentation Title

Fig. 02 -

CHAMPION Trial Design

Fig. 03 -

PAP Measurement System

Fig. 04 -

CHAMPION PA Target Pressures

Fig. 05 -

Clinical outcomes

Fig. 06 -

PAP-M: Reduces hospitalizations

Fig. 07 -

PAP-M: Benefits and comorbidities

Fig. 08 -

PAP-M: Better than GDMT

Fig. 09 -

PAP-M: Lowers mortality

Fig. 10 -

CHAMPION lowers 30-day readmissions

Fig. 11 -

CHAMPION: Effect on CMS HRRP

Fig. 12 -

CHAMPION: Longitudinal analysis(1)

Fig. 13 -

CHAMPION: Longitudinal analysis(2)

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The American Journal of Cardiology

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Abraham - Figure 4

Champion Clinical Trial: Managing to Target PA Pressures

The CHAMPION trial assessed managing PAP levels to target values so that regardless of patient signs or symptoms, regardless of whether or not the patient felt well, and regardless of whether the clinician thought that the patient looked well, the trial protocol encouraged the treating physicians to lower patient PAP levels into the target ranges shown in Figure 4.^[1,2] For example, the target range for pulmonary artery diastolic pressure was 8–20 mmHg [systolic 15–35 mmHg, mean 10–25 mmHg].

This was accomplished with very simple protocol-driven treatment algorithms, such as the one shown in Figure 4. If the PAP values were elevated, implying that the patient was wet, the investigator was encouraged to add or increase the dose of a diuretic. If that medication adjustment alone did not result in a reduction in the PAP, then the investigator was encouraged to add or to increase the dose of a vasodilator.

Abraham WT. Am J Cardiol. 2015; 00.

References

[1]

Abraham WT, Adamson PB, Bourge RC, et al; CHAMPION Trial Study Group. Wireless pulmonary artery haemodynamic monitoring in chronic heart failure: a randomised controlled trial. Lancet. 2011;377:658-666.

[2]

Adamson PB, Abraham WT, Aaron M, et al. CHAMPION trial rationale and design: The long-term safety and clinical efficacy of a wireless pulmonary artery pressure monitoring system. J Cardiac Fail. 2011;17:3-10.

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