The Benefits of Ambulatory Pulmonary Artery Pressure Monitoring in Patients with Heart Failure

Abstract

Purpose CHAMPION trial showed a reduction in CHF hospitalizations with the utilization of the CardioMEMS device. We hope to expand on this trial by correlating pulmonary artery pressure to other variables of volume status, such as creatinine, pro-BNP, hematocrit, iron levels, and body weight, in the patient population we currently serve to help analyze the efficiency of their current HF regimen and help formulate any required adjustments to prevent future CHF exacerbation hospitalizations. Methods We retrospectively investigated all of our CardioMEMS patients who were hospitalized after CARDIOMEMS placement over a course of 1 year for CHF exacerbation. We followed them from baseline to hospitalization to discharge to clinic follow up while monitoring several variables, including pulmonary artery pressures, creatinine, pro-BNP, hematocrit, iron levels and body weight. All data was primarily collected via the Merlin.net™ Patient Care Network - Heart Failure Management Database and EPIC EMR. Necessary diuretic regimens were adjusted according to these variables. Results Our analysis showed a direct correlation with pulmonary artery pressure with pro-BNP and body weight and an inverse relationship with creatinine, iron levels, and hematocrit at the time of admission suggesting evidence of volume overload and increased ventricular wall stress. Pro-BNP displayed a strong, positive, relative linear relationship (Pearson Correlation of 0.609 and r of 0.63) and hematocrit had a similar inverse (strong, negative, linear) (Pearson Correlation of 0.713 and r of -0.58) relationship with pulmonary artery pressure, compared to the other variables. These variables displayed a similar inverse relationship as patients were adequately diuresed during their hospitalization and subsequently discharged home. We also saw 42% reduction in length of hospital stay and 56% 30 day readmission rates in our study patient population. Conclusion Our retrospective analysis confirmed that results endorsed by the CHAMPION trial by showing a significant reduction in hospitalization of our CardioMEMS patients. Concurrently, we also advocate the benefit of Pro-BNP and hematocrit levels as strong positive correlating factors to determine volume status.