What question did this study set out to answer?

To determine whether pulmonary artery pressures vary significantly between morning and nighttime measurements in ambulatory heart failure patients utilizing an implanted sensor.

July 29, 2022Acta cardiologica. Supplementum

Diurnal variation of pulmonary artery pressure in ambulatory heart failure patients

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Why the study?

There is limited information on diurnal variation in pulmonary artery pressures in ambulatory heart failure patients.

Does pulmonary artery pressure vary diurnally in ambulatory heart failure patients with an implanted CardioMEMS sensor?

Key Points

To determine whether pulmonary artery pressures vary significantly between morning and nighttime measurements in ambulatory heart failure patients utilizing an implanted sensor.
Prospective, single-center study evaluating 30 ambulatory heart failure patients with an implanted CardioMEMS sensor, excluding individuals with end-stage renal disease or recent heart failure hospitalizations.
Participants transmitted pulmonary artery pressure, non-invasive systemic blood pressure, and pulse rate readings twice daily (morning and night) over 7 consecutive days.
Diurnal pressure differences across subgroups were assessed using repeated-measures ANOVA, and correlations with left ventricular ejection fraction were evaluated using Pearson correlation coefficients.
Pulmonary artery systolic pressure significantly increased at night compared to morning measurements (+2.59 mmHg, p = 0.003), as did mean pulmonary artery pressure (+1.24 mmHg, p = 0.02).
Nighttime pulmonary artery diastolic pressure showed no statistically significant change (+0.48 mmHg, p = 0.18), with systemic blood pressure and pulse rate also remaining unchanged across time points.

Structured PICO

Does pulmonary artery pressure vary diurnally in ambulatory heart failure patients with an implanted CardioMEMS sensor?

Population

30 ambulatory heart failure patients with an implanted CardioMEMS sensor. Exclusions: End stage renal disease and recent hospitalisation for acute HF.

Intervention

Measurement of pulmonary artery pressures (PAP) and non-invasive blood pressure in the morning and at night-time for 7 consecutive days

Comparator

Morning readings vs night-time readings

Outcome

Variation in morning and night-time pulmonary artery pressures (PASP, mPAP, PADP)surrogate

Ambulatory heart failure patients exhibit a significant nocturnal rise in systolic and mean pulmonary artery pressures, suggesting clinical decisions should account for the time of day readings are taken.

Authors

PSPrince SethiMercy Hospital Springfield PLPayton LancasterUniversity of Kansas Medical Center BSBrianna StackUniversity of Kansas Medical Center

Discussion

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Implication

Nocturnal PAP rises may require timing-adjusted thresholds in CardioMEMS monitoring; leaves open need for outcome trials before practice change.

Cite This Study

Sethi et al. (2022) studied this question.

synapsesocial.com/papers/6a73a03ed3d4e530dbfb7170 https://doi.org/10.1080/00015385.2022.2101777

Topics

HFrEF treatment Heart failure

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Implication

Nocturnal PAP rises may require timing-adjusted thresholds in CardioMEMS monitoring; leaves open need for outcome trials before practice change.

Diurnal variation of pulmonary artery pressure in ambulatory heart failure patients

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

Diurnal variation of pulmonary artery pressure in ambulatory heart failure patients

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider