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 7

PAP-Guided HF Management Benefits Patients with Common HF Comorbidities

Other important subgroups in the CHAMPION Trial were investigated, particularly those HF patients with common comorbidities – such as history of myocardial infarction,^[5] chronic obstructive pulmonary disease (COPD),[6] pulmonary hypertension,^[7] atrial fibrillation,^[8] or chronic kidney disease (CKD).^[9] As depicted in Figure 7 reporting data from several sources of information, there were consistent reductions in HF hospitalizations across all of these CHAMPION patient subpopulations with common HF comorbidities.

For example, the COPD population represents a particularly challenging group of HF patients (because it is often difficult to know if their worsening shortness of breath is related to worsening HF or to worsening or exacerbation of their COPD), and yet in these challenging patients PAP-guided HF therapy produced a 41% reduction in the risk of HF hospitalization.^[6] Similarly, in another high-risk population, HF patients with CKD, PAP-guided HF management was both safe and effective, and moreover was not associated with any worsening of renal function.^[9]

Abraham WT. Am J Cardiol. 2015; 00.

References

[5]

Strickland WL, Parrott CW, Abraham WT, et al. The utility of remote wireless pulmonary artery pressure monitoring in patients with or without a history of myocardial infarction: Experience from the CHAMPION Trial. J Am Coll Cardiol. 2011;58(20 Suppl B):B130. Abstract TCT-479.

[6]

Krahnke JS, Abraham WT, Adamson PB, et al; Champion Trial Study Group. Heart failure and respiratory hospitalizations are reduced in patients with heart failure and chronic obstructive pulmonary disease with the use of an implantable pulmonary artery pressure monitoring device. J Card Fail. 2015;21:240-249.

[7]

Benza RL, Raina A, Abraham WT, et al. Pulmonary hypertension related to left heart disease: Insight from a wireless implantable hemodynamic monitor. J Heart Lung Transplant. 2015;34:329-337.

[8]

Miller AB, Teerlink J, Carson P, et al. Impact of remote, wireless pulmonary artery hemodynamic monitoring in patients with atrial fibrillation and chronic heart failure: insights from the CHAMPION trial. J Am Coll Cardiol. 2012;59(13 suppl):E868.

[9]

Abraham WT, Adamson PB, Stevenson LW, et al. Benefits of pulmonary artery pressure monitoring in patients with NYHA Class III heart failure and chronic kidney disease: Results from the CHAMPION trial. J Cardiac Fail. 2014;20(8 suppl):S93. Abstract 233.

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