Remote monitoring program in patients with pulmonary hypertension: the French experience

Introduction Patients with pulmonary hypertension (PH) either pre- or post-capillary, are at high risk of mortality or morbidity (i.e., unscheduled hospitalization for acute heart failure [HF]). Remote monitoring program (RMP) is a promising solution to reduce mortality and morbidity among patients with left HF but there is actually no data regarding patients with PH, especially in patients with pre-capillary PH. Objective Within a large cohort of patients followed by a RPM (Satelia Cardio), to compare the main characteristics of patients with PH compared to HF patients without PH. Method All patients followed by RPM from January 2019 to December 2023 in France (280 centers) were included in this retrospective analysis. Patients were divided as follow: patients with left HF, regardless of left ventricular ejection fraction (LVEF), but no PH ("no PH" group), patients left HF and post-capillary PH ("post-capillary PH" group), and patients with pre-capillary PH ("pre-capillary PH" group). Results 15,789 patients were included in this analysis (median age was 77 (67, 85) years-old, 64% of male, LVEF averaged 40±10%, and the median of follow-up with remote monitoring was 12 (5, 23) months) and were distributed as follow: 15,325 (97%) in the "no PH group", 434 (2.7%) in the "post-capillary PH" group and 30 (0.3%) in the "pre-capillary PH" group. The main characteristics of the patients are summarized in Table 1. Not surprisingly, patients with post-capillary PH were more likely to be aging patients with higher number of comorbidities and cardiovascular risk factors. A large majority of patients had an excellent adherence to the RMP and patients with pre-capillary PH were more likely to have higher adherence (p=0.003). Interestingly, even if not significant, patients with pre-capillary PH were more likely to raise a remote monitoring alert and to be hospitalized at least once for AHF (p=0.051 and mean number of hospitalization higher in pre-capillary versus post-capillary PH, p=0.006). Conclusion These results suggest that RMP adherence is high in patients with PH and suggest embedding remote monitoring into daily clinical practice, even in pre-capillary PH. More data regarding RMP impact on mortality and morbidity are now mandatory.