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 8

Impact of PAP-Guided HF Management on HF Hospitalizations in GDMT Population

Another population subset explored in the CHAMPION Trial was the cohort of HF with reduced EF (HFrEF) patients on optimal guideline-directed medical therapy (GDMT). This was important because after the CHAMPION results were shown to be successful, one of the questions was whether PAP-guided HF management primarily helps patients who aren’t already managed very well, or is this approach valuable even in patients who are successfully managed with GDMT?

In the CHAMPION Trial about half of the enrolled patients were on GDMT, meaning that these HFrEF patients were on good doses on beta blockers and ACE inhibitors or ARBs, at a minimum. If indicated, these patients had received CRT and ICD devices, and many were also on aldosterone antagonists. Yet as shown in Figure 8, analysis of the CHAMPION GDMT patient subset demonstrated a further 43% reduction in the risk of HF hospitalization on top of GDMT.^[10]

In other words, use of PAP-guided HF management reduces hospitalizations and adds value on top of well-managed GDMT alone.

Abraham WT. Am J Cardiol. 2015; 00.

References

[10]

Abraham WT, Adamson P, Stevenson L, et al. Pulmonary artery pressure management in heart failure patients with reduced ejection fraction significantly reduces heart failure hospitalizations and mortality above and beyond background guideline-directed medical therapy. J Am Coll Cardiol. 2015;65(10S):A790.

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