PMID- 27878990
OWN - NLM
STAT- MEDLINE
DCOM- 20170615
LR  - 20220409
IS  - 1932-8737 (Electronic)
IS  - 0160-9289 (Print)
IS  - 0160-9289 (Linking)
VI  - 40
IP  - 3
DP  - 2017 Mar
TI  - Hemodynamic-guided heart-failure management using a wireless implantable sensor: 
      Infrastructure, methods, and results in a community heart failure 
      disease-management program.
PG  - 170-176
LID - 10.1002/clc.22643 [doi]
AB  - BACKGROUND: The real-world impact of remote pulmonary artery pressure (PAP) 
      monitoring on New York Heart Association (NYHA) class improvement and heart 
      failure (HF) hospitalization rate is presented here from a single center. 
      HYPOTHESIS: METHODS: Seventy-seven previously hospitalized outpatients with NYHA 
      class III HF were offered PAP monitoring via device implantation in a 
      multidisciplinary HF-management program. Prospective effectiveness analyses 
      compared outcomes in 34 hemodynamically monitored patients to a group of similar 
      patients (n = 32) who did not undergo device implantation but received usual 
      care. NYHA class and 6-minute walk testing were assessed at baseline and 90 days. 
      All hospitalizations were collected after 6 months of the implantation date 
      (average follow-up, 15 months) and compared with the number of hospitalizations 
      experienced prior to hemodynamic monitoring. RESULTS: Patients in both groups had 
      similar distributions of age, sex, and ejection fraction. After 90 days, 61.8% of 
      the monitored patients had NYHA class improvement of >/=1, compared with 12.5% in 
      the controls (P < 0.001). Distance walked in 6 minutes increased by 54.5 meters 
      in the monitored group (253.0 +/- 25.6 meters to 307.4 +/- 26.3 meters; P < 0.005), 
      whereas no change was seen in the usual-care group. After implantation, 19.4% of 
      the monitored group had >/=1 HF hospitalization, compared with 100% who had been 
      hospitalized in the year prior to implantation. The monitored group had a 
      significantly lower HF hospitalization rate (0.16; 95% confidence interval: 
      0.06-0.35 hospitalizations/patient-year) compared with the year prior (1.0 
      hospitalizations/patient-year; P < 0.001). CONCLUSIONS: Hemodynamic-guided HF 
      management leads to significant improvements in NYHA class and HF hospitalization 
      rate in a real-world setting compared with usual care delivered in a 
      comprehensive disease-management program.
CI  - (c) 2016 Wiley Periodicals, Inc.
FAU - Jermyn, Rita
AU  - Jermyn R
AD  - Department of Medicine, Division of Cardiology, Northwell Health, Manhasset, New 
      York.
FAU - Alam, Amit
AU  - Alam A
AD  - Department of Medicine, Division of Cardiology, Northwell Health, Manhasset, New 
      York.
FAU - Kvasic, Jessica
AU  - Kvasic J
AD  - Department of Medicine, Division of Cardiology, Northwell Health, Manhasset, New 
      York.
FAU - Saeed, Omar
AU  - Saeed O
AD  - Division of Cardiology, Montefiore Medical Center, Bronx, New York.
FAU - Jorde, Ulrich
AU  - Jorde U
AD  - Division of Cardiology, Montefiore Medical Center, Bronx, New York.
LA  - eng
PT  - Journal Article
DEP - 20161123
PL  - United States
TA  - Clin Cardiol
JT  - Clinical cardiology
JID - 7903272
SB  - IM
MH  - Aged
MH  - *Disease Management
MH  - *Electrodes, Implanted
MH  - Equipment Design
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/*diagnosis/physiopathology/therapy
MH  - Hemodynamics/*physiology
MH  - Hospitalization/trends
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Monitoring, Physiologic/*instrumentation
MH  - *Program Evaluation
MH  - Prospective Studies
MH  - Remote Sensing Technology/instrumentation
MH  - Stroke Volume
MH  - Telemedicine/*instrumentation
MH  - Time Factors
PMC - PMC6490562
OTO - NOTNLM
OT  - Heart failure
OT  - cardiac transplantation
OT  - cardiomyopathy
OT  - myocarditis
EDAT- 2016/11/24 06:00
MHDA- 2019/03/21 06:00
PMCR- 2016/11/23
CRDT- 2016/11/24 06:00
PHST- 2016/08/01 00:00 [received]
PHST- 2016/10/11 00:00 [revised]
PHST- 2016/10/13 00:00 [accepted]
PHST- 2016/11/24 06:00 [pubmed]
PHST- 2019/03/21 06:00 [medline]
PHST- 2016/11/24 06:00 [entrez]
PHST- 2016/11/23 00:00 [pmc-release]
AID - CLC22643 [pii]
AID - 10.1002/clc.22643 [doi]
PST - ppublish
SO  - Clin Cardiol. 2017 Mar;40(3):170-176. doi: 10.1002/clc.22643. Epub 2016 Nov 23.