PMID- 37013072
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230405
IS  - 2589-790X (Electronic)
IS  - 2589-790X (Linking)
VI  - 5
IP  - 3
DP  - 2023 Mar
TI  - Ambulatory Pulmonary Artery Pressure Monitoring Reduces Costs and Improves 
      Outcomes in Symptomatic Heart Failure: A Single-Centre Canadian Experience.
PG  - 237-249
LID - 10.1016/j.cjco.2022.12.008 [doi]
AB  - BACKGROUND: Pulmonary artery pressure (PAP) monitoring reduces heart failure (HF) 
      hospitalizations (HFHs) and improves quality of life in New York Heart 
      Association (NYHA) class III HF. We evaluated the impact of PAP monitoring on 
      outcomes and health spending in a Canadian ambulatory HF cohort. METHODS: Twenty 
      NYHA III HF patients underwent wireless PAP implantation at Foothills Medical 
      Centre, Calgary, Alberta. Baseline, and 3-, 6-, 9-, and 12-month assessments of 
      laboratory parameters, hemodynamics, 6-minute walk text and Kansas City 
      Cardiomyopathy Questionnaire scores were collected. Healthcare costs 1 year pre- 
      and post-implantation were collected from administrative databases. RESULTS: Mean 
      age was 70.6 years; 45% were female. Results were as follows: an 88% reduction in 
      emergency room visits (P = 0.0009); an 87% reduction in HFHs (P < 0.0003); a 29% 
      reduction in heart function clinic visits (P = 0.033), and a 178% increase in 
      nurse calls (P < 0.0002). Questionnaire and 6-minute walk test scores at baseline 
      vs last follow-up were 45.4 vs 48.4 (P = 0.48) and 364.4 vs 402.8 m (P = 0.58), 
      respectively. Mean PAP at baseline vs follow-up was 31.5 vs 24.8 mm Hg (P = 
      0.005). NYHA class improved by at least one class in 85% of patients. Mean 
      measurable HF-related spending preimplantation was CAD$29,814 per patient per 
      year and postimplantation was CAD$25,642 per patient per year (including device 
      cost). CONCLUSIONS: PAP monitoring demonstrated reductions in HFHs, and emergency 
      room and heart function clinic visits, with improvements in NYHA class. Although 
      further economic evaluation is needed, these results support the use of PAP 
      monitoring as an effective and cost-neutral tool in HF management in 
      appropriately selected patients in a publicly funded healthcare system.
CI  - (c) 2022 The Authors.
FAU - Gibson, Jordan
AU  - Gibson J
AD  - Libin Cardiovascular Institute and Department of Cardiac Sciences, Foothills 
      Medical Centre, University of Calgary, Calgary Alberta, Canada.
FAU - McGrath, Kaitlin
AU  - McGrath K
AD  - Libin Cardiovascular Institute and Department of Cardiac Sciences, Foothills 
      Medical Centre, University of Calgary, Calgary Alberta, Canada.
FAU - Miller, Robert J H
AU  - Miller RJH
AD  - Libin Cardiovascular Institute and Department of Cardiac Sciences, Foothills 
      Medical Centre, University of Calgary, Calgary Alberta, Canada.
FAU - Sumner, Glen
AU  - Sumner G
AD  - Libin Cardiovascular Institute and Department of Cardiac Sciences, Foothills 
      Medical Centre, University of Calgary, Calgary Alberta, Canada.
FAU - Clarke, Brian
AU  - Clarke B
AD  - Libin Cardiovascular Institute and Department of Cardiac Sciences, Foothills 
      Medical Centre, University of Calgary, Calgary Alberta, Canada.
LA  - eng
PT  - Journal Article
DEP - 20221226
PL  - United States
TA  - CJC Open
JT  - CJC open
JID - 101763635
PMC - PMC10066443
EDAT- 2023/04/05 06:00
MHDA- 2023/04/05 06:01
PMCR- 2022/12/26
CRDT- 2023/04/04 01:59
PHST- 2022/09/07 00:00 [received]
PHST- 2022/12/20 00:00 [accepted]
PHST- 2023/04/05 06:01 [medline]
PHST- 2023/04/04 01:59 [entrez]
PHST- 2023/04/05 06:00 [pubmed]
PHST- 2022/12/26 00:00 [pmc-release]
AID - S2589-790X(22)00294-3 [pii]
AID - 10.1016/j.cjco.2022.12.008 [doi]
PST - epublish
SO  - CJC Open. 2022 Dec 26;5(3):237-249. doi: 10.1016/j.cjco.2022.12.008. eCollection 
      2023 Mar.