PMID- 36456066
OWN - NLM
STAT- MEDLINE
DCOM- 20221205
LR  - 20221227
IS  - 2213-1787 (Electronic)
IS  - 2213-1779 (Linking)
VI  - 10
IP  - 12
DP  - 2022 Dec
TI  - Hemodynamically-Guided Management of Heart Failure Across the Ejection Fraction 
      Spectrum: The GUIDE-HF Trial.
PG  - 931-944
LID - S2213-1779(22)00512-1 [pii]
LID - 10.1016/j.jchf.2022.08.012 [doi]
AB  - BACKGROUND: Hemodynamically-guided management using an implanted pulmonary artery 
      pressure sensor is indicated to reduce heart failure (HF) hospitalizations in 
      patients with New York Heart Association (NYHA) functional class II-III with a 
      prior HF hospitalization or those with elevated natriuretic peptides. OBJECTIVES: 
      The authors sought to evaluate the effect of left ventricular ejection fraction 
      (EF) on treatment outcomes in the GUIDE-HF (Hemodynamic-GUIDEd management of 
      Heart Failure) randomized trial. METHODS: The GUIDE-HF randomized arm included 
      1,000 NYHA functional class II-IV patients (with HF hospitalization within the 
      prior 12 months or elevated natriuretic peptides adjusted for EF and body mass 
      index) implanted with a pulmonary artery pressure sensor, randomized 1:1 to a 
      hemodynamically-guided management group (treatment) or a control group (control). 
      The primary endpoint was the composite of HF hospitalizations, urgent HF visits, 
      and all-cause mortality at 12 months. The authors assessed outcomes by EF in 
      guideline-defined subgroups </=40%, 41%-49%, and >/=50%, within the trial specified 
      pre-COVID-19 period cohort. RESULTS: There were 177 primary events 
      (0.553/patient-year) in the treatment group and 224 events (0.682/patient-year) 
      in the control group (HR: 0.81 [95% CI: 0.66-1.00]; P = 0.049); HF 
      hospitalization was lower in the treatment vs control group (HR: 0.72 [95% CI: 
      0.57-0.92]; P = 0.0072). Within each EF subgroup, primary endpoint and HF 
      hospitalization rates were lower in the treatment group (HR <1.0 across the EF 
      spectrum). Event rate reduction by EF in the treatment groups was correlated with 
      reduction in pulmonary artery pressures and medication changes. CONCLUSIONS: 
      Hemodynamically-guided HF management decreases HF-related endpoints across the EF 
      spectrum in an expanded patient population of patients with HF. 
      (Hemodynamic-GUIDEd Management of Heart Failure [GUIDE-HF]; NCT03387813).
CI  - Copyright (c) 2022 The Authors. Published by Elsevier Inc. All rights reserved.
FAU - Zile, Michael R
AU  - Zile MR
AD  - Medical University of South Carolina, RJH Department of Veterans Affairs Medical 
      Center, Charleston, South Carolina, USA. Electronic address: zilem@musc.edu.
FAU - Mehra, Mandeep R
AU  - Mehra MR
AD  - Cardiology Division, Brigham and Women's Hospital, and Harvard Medical School, 
      Boston, Massachusetts, USA.
FAU - Ducharme, Anique
AU  - Ducharme A
AD  - Montreal Heart Institute, Universite de Montreal, Montreal, Quebec, Canada.
FAU - Sears, Samuel F
AU  - Sears SF
AD  - East Carolina University, Greenville, North Carolina, USA.
FAU - Desai, Akshay S
AU  - Desai AS
AD  - Cardiology Division, Brigham and Women's Hospital, and Harvard Medical School, 
      Boston, Massachusetts, USA.
FAU - Maisel, Alan
AU  - Maisel A
AD  - University of California-San Diego, La Jolla, California, USA.
FAU - Paul, Sara
AU  - Paul S
AD  - Catawba Valley Health System, Conover, North Carolina, USA.
FAU - Smart, Frank
AU  - Smart F
AD  - Louisiana State University School of Medicine, New Orleans, Louisiana, USA.
FAU - Grafton, Gillian
AU  - Grafton G
AD  - Henry Ford Hospital, Detroit, Michigan, USA.
FAU - Kumar, Sachin
AU  - Kumar S
AD  - Memorial Hermann Hospital, Houston, Texas, USA.
FAU - Nossuli, Tareck O
AU  - Nossuli TO
AD  - The Heart Group of Lancaster General Health, Lancaster, Pennsylvania, USA.
FAU - Johnson, Nessa
AU  - Johnson N
AD  - Abbott, Abbott Park, Illinois, USA.
FAU - Henderson, John
AU  - Henderson J
AD  - Abbott, Abbott Park, Illinois, USA.
FAU - Adamson, Philip B
AU  - Adamson PB
AD  - Abbott, Abbott Park, Illinois, USA.
FAU - Costanzo, Maria Rosa
AU  - Costanzo MR
AD  - Midwest Cardiovascular Institute, Naperville, Illinois, USA.
FAU - Lindenfeld, JoAnn
AU  - Lindenfeld J
AD  - Vanderbilt Heart and Vascular Institute, Nashville, Tennessee, USA.
LA  - eng
SI  - ClinicalTrials.gov/NCT03387813
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20221012
PL  - United States
TA  - JACC Heart Fail
JT  - JACC. Heart failure
JID - 101598241
SB  - IM
CIN - JACC Heart Fail. 2022 Dec;10(12):945-947. PMID: 36456067
MH  - Humans
MH  - Stroke Volume
MH  - Ventricular Function, Left
MH  - *Heart Failure/therapy
MH  - *COVID-19
MH  - Body Mass Index
OTO - NOTNLM
OT  - ejection fraction
OT  - heart failure
OT  - hemodynamics
OT  - pulmonary artery pressure
COIS- Funding Support and Author Disclosures Funding was provided by Abbott. The 
      authors have reported that they have no relationships relevant to the contents of 
      this paper to disclose.
EDAT- 2022/12/02 06:00
MHDA- 2022/12/06 06:00
CRDT- 2022/12/01 21:05
PHST- 2022/06/16 00:00 [received]
PHST- 2022/08/15 00:00 [revised]
PHST- 2022/08/17 00:00 [accepted]
PHST- 2022/12/01 21:05 [entrez]
PHST- 2022/12/02 06:00 [pubmed]
PHST- 2022/12/06 06:00 [medline]
AID - S2213-1779(22)00512-1 [pii]
AID - 10.1016/j.jchf.2022.08.012 [doi]
PST - ppublish
SO  - JACC Heart Fail. 2022 Dec;10(12):931-944. doi: 10.1016/j.jchf.2022.08.012. Epub 
      2022 Oct 12.