Hemodynamic monitoring tied to improved QoL among heart failure patients: Monitor-HF Trial

A study published in the Lancet has concluded that those patients who were assigned to hemodynamic monitoring reported to have improved quality of life compared to those receiving contemporary guideline-directed medical therapy among heart failure patients. In their study, researchers found that rate of hospitalizations due to heart failure got reduced by 44% in the hemodynamic monitoring group compared to the control.

This study was led by Dr Jasper J Brugts, MD and colleagues.

Explaining study background, In USA, they said previous researches have already highlighted the effect of haemodynamic monitoring of pulmonary artery pressure.

There needs to be more data for better understanding from patients treated with contemporary guideline-directed-medical-therapy with long-term follow-up in a different health-care system.

MONITOR-HF was an open-label, randomised trial. It was conducted in 25 centres in the Netherlands. Eligible patients had history of chronic heart failure (New York Heart Association class III), hospitalisation due to previous heart failure irrespective of ejection fraction.

Patients were randomly assigned at 1:1 in two groups, haemodynamic monitoring and standard care. All patients met clinician at 3 months and 6 months, and every 6 months thereafter, up to period of 48 months.

The mean difference in the KCCQ overall summary score at 12 months was the primary endpoint.

The findings of the study are:

• 348 patients of median age 69 years were randomly assigned to the CardioMEMS-HF group (176 patients) and the control group (172 patients).

• The median ejection fraction was 30%.

• Researchers found difference in mean change in KCCQ overall summary score at 12 months as 7·13 between groups.

• The odds ratio (OR) of an improvement of at least 5 points in KCCQ overall summary score was OR 1·69.

• In comparison to the standard group, calculated OR of a deterioration of at least 5 points was 0·45 in the CardioMEMS-HF group.

• The freedom of device-related or system-related complications and sensor failure were 97·7% and 98·8%, respectively.

Researchers said that, in our study, we found that “In patients with history of moderate-to- severe heart failure who were treated according to contemporary guidelines, Haemodynamic monitoring improved quality of life and reduced heart failure hospitalisations”

The study provides aggregate evidence for the technology and might have implications for guideline recommendations and implementation of remote pulmonary artery pressure monitoring.

As acknowledged, The Dutch Ministry of Health, Health Care Institute (Zorginstituut), and Abbott Laboratories funded the study.

Further reading:

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00923-6/fulltext