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Relationship Between Ambulatory Pulmonary Artery Pressures and Heart Failure Hospitalizations in Patients With Chronic Heart Failure
Key result
Baseline diastolic pulmonary artery pressure was an independent predictor of heart failure hospitalization within 2 years.
Why the study?
It was unknown whether baseline ambulatory pulmonary artery pressures and changes in pressures to 6 months were independent predictors of heart failure hospitalization within 2 years.
Do baseline ambulatory pulmonary artery pressures and changes in pressures over 6 months predict heart failure hospitalization within 2 years in patients with chronic heart failure?
Study Design
Type
Cohort (n=4,342)
Multicenter
Yes
Structured PICO
Do baseline ambulatory pulmonary artery pressures and changes in pressures over 6 months predict heart failure hospitalization within 2 years in patients with chronic heart failure?
P
Population
4,342 patients with chronic heart failure (reduced and preserved ejection fraction) from 4 CardioMEMS studies, evaluated over a 2-year follow-up.
E
Exposure
Ambulatory pulmonary artery pressure (PAP) monitoring (baseline and change from baseline to 6 months)
O
Outcome
Heart failure hospitalization (HFH) within 2 yearshard clinical
Main Result
Hazard Ratio: 1.043 (95% CI 1.035–1.05)
p-value: p=< 0.0001
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Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“The results of the analyses presented in this study support novel, clinically actionable insights into the relationship between PAPs and the risk of HFHs. These data support the central pivotal role that pressures play in the prognosis of all patients with chronic HF and the opportunity to prevent HF outcomes by applying hemodynamically guided care to patients with chronic HF.”
Implication
Baseline and 6-month changes in ambulatory pulmonary artery pressures are independent predictors of heart failure hospitalization within 2 years in patients with chronic heart failure.
Abstract
BACKGROUND Pulmonary artery pressure (PAP) monitors provide ambulatory hemodynamic assessment of patients with chronic heart failure (HF). OBJECTIVES The current analysis was designed to determine whether baseline systolic, diastolic, and mean PAPs and changes in PAPs from baseline to 6 months each were independent predictors of a heart failure hospitalization (HFH) within 2 years. METHODS Retrospective analysis of CardioMEMS data from 4 studies including CHAMPION (CardioMEMS Heart Sensor Allows Monitoring of Pressure to Improve Outcomes) (n = 550), GUIDE-HF (Hemodynamic-GUIDEed Management of Heart Failure) (n = 2,358), US PAS (CardioMEMS HF System Post Approval Study) (n = 1,200), and MEMS-HF (CardioMEMS Monitoring Study for Heart Failure) (n = 234) included all enrolled patients regardless of treatment assignment (N = 4,342), reduced ejection fraction (<50%) (n = 2,562), and preserved ejection fraction (≥50%) (n = 1,454). Relationships between baseline pressure (averaged over 14 days after implantation) and change in pressure from baseline to 6 months (averaged over 14 days just before the 6-month time point) and HFH risk were evaluated over a 2-year follow-up. RESULTS Baseline diastolic PAP was an independent predictor of HFH (HR: 1.043 [95% CI: 1.035-1.050]; P < 0.0001). Change in diastolic PAP (baseline to 6 months, assessed as a continuous variable) was an independent predictor of HFH (landmark analysis; HR: 1.047 [95% CI: 1.035-1.0506]; P < 0.0001). A decrease or increase of >2 mm Hg in diastolic PAP (baseline to 6 months, assessed as categorical variable) compared with no change predicted a 16.1% decrease and 50.1% increase in HFH (P < 0.0001). Results were comparable for systolic and mean PAPs and for patients with HF with reduced ejection fraction and HF with preserved ejection fraction. CONCLUSIONS Baseline PAP and change in PAP from baseline to 6 months (systolic, diastolic, and mean) were independent predictors of HFH within 2 years. Current and previous data from 4 studies using CardioMEMS indicate that PAP is an independent predictor of both mortality and HFH.
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Cite This Study
Zile et al. (2026) conducted a cohort in Chronic heart failure (n=4,342). Baseline and change in pulmonary artery pressure (PAP) vs. Lower baseline PAP or no change in PAP was evaluated on Heart failure hospitalization (HFH) within 2 years (HR 1.043, 95% CI 1.035-1.050, p=< 0.0001). Baseline diastolic pulmonary artery pressure was an independent predictor of heart failure hospitalization within 2 years.