The favourable alliance between CardioMEMS and levosimendan in patients with advanced heart failure.

Abstract

We report the results of a real-world study based on heart failure (HF) patients' continuous remote monitoring strategy using the CardioMEMS system to assess the impact of this device on healthcare outcomes, costs, and patients' management and quality of life. We enrolled seven patients (69.00±4.88years; 71.43% men) with HF, implanted with CardioMEMS, and daily remote monitored to optimize both tailored adjustments of home therapy and/or hospital infusions of levosimendan. We recorded clinical, pharmacological, biochemical, and echocardiographic parameters and data on hospitalizations, emergency room access, visits, and costs. Following the implantation of CardioMEMS, we observed a 50% reduction in the total number of hospitalizations and a 68.7% reduction in the number of days in the hospital. Accordingly, improved patient quality of life was recorded with EQ-5D (pre 58.57±10.29 vs. 1year post 84.29±19.02, P=0.008). Echocardiographic data show a statistically significant improvement in both systolic pulmonary artery pressure (47.86±8.67 vs. 35.14±9.34, P=0.022) and E/e' (19.33±5.04 vs. 12.58±3.53, P=0.023). The Quantikine® HS High-Sensitivity Kit determined elevated interleukin-6 values at enrolment in all patients, with a statistically significant reduction after 6months (P=0.0211). From an economic point of view, the net savings, including the cost of CardioMEMS, were on average €1580 per patient during the entire period of observation, while the analysis performed 12months after the implant vs. 12months before showed a net saving of €860 per patient. The ad hoc analysis performed on the levosimendan infusions resulted in 315days of hospital avoidance and a saving of €205158 for the seven patients enrolled during the observation period. This innovative strategy prevents unplanned access to the hospital and contributes to the efficient use of healthcare facilities, human resources, and costs.