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Abstract
Heart failure (HF) poses a significant challenge, often leading to frequent hospitalizations and compromised quality of life. Continuous pulmonary artery pressure (PAP) monitoring offers a surrogate for congestion status in ambulatory HF care. This meta-analysis examines the efficacy of PAP monitoring devices (CardioMEMS and Chronicle) in preventing adverse outcomes in HF patients, addressing gaps in prior randomized controlled trials (RCTs). Five RCTs (2572 participants) were systematically reviewed. PAP monitoring significantly reduced HF-related hospitalizations (RR 0.72 [95% CI 0.6–0.87], p = 0.0006) and HF events (RR 0.86 [95% CI 0.75–0.99], p = 0.03), with no impact on all-cause or cardiovascular mortality. Subgroup analyses highlighted the significance of CardioMEMS and blinded studies. Meta-regression indicated a correlation between prolonged follow-up and increased reduction in HF hospitalizations. The risk of bias was generally high, with evidence certainty ranging from low to moderate. PAP monitoring devices exhibit promise in diminishing HF hospitalizations and events, especially in CardioMEMS and blinded studies. However, their influence on mortality remains inconclusive. Further research, considering diverse patient populations and intervention strategies with extended follow-up, is crucial for elucidating the optimal role of PAP monitoring in HF management.
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Details
1 Wroclaw Medical University, Institute of Heart Diseases, University Clinical Hospital in Wroclaw, Wrocław, Poland (GRID:grid.4495.c) (ISNI:0000 0001 1090 049X)
2 University Clinical Hospital in Wroclaw, Institute of Heart Diseases, Wrocław, Poland (GRID:grid.4495.c)
3 University Clinical Hospital in Wroclaw, Institute of Heart Diseases, Wrocław, Poland (GRID:grid.4495.c); Wroclaw Medical University, Department of Physiology and Pathophysiology, Wrocław, Poland (GRID:grid.4495.c) (ISNI:0000 0001 1090 049X)
4 Wroclaw Medical University, Department and Clinic of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, University Clinical Hospital in Wroclaw, Wrocław, Poland (GRID:grid.4495.c) (ISNI:0000 0001 1090 049X)
5 Wroclaw Medical University, Department and Clinic of Otolaryngology, Head and Neck Surgery, University Clinical Hospital in Wroclaw, Wrocław, Poland (GRID:grid.4495.c) (ISNI:0000 0001 1090 049X)