@article{AngermannAssmusAnkeretal.2020, author = {Angermann, Christiane E. and Assmus, Birgit and Anker, Stefan D. and Asselbergs, Folkert W. and Brachmann, Johannes and Brett, Marie-Elena and Brugts, Jasper J. and Ertl, Georg and Ginn, Greg and Hilker, Lutz and Koehler, Friedrich and Rosenkranz, Stephan and Zhou, Qian and Adamson, Philip B. and B{\"o}hm, Michael}, title = {Pulmonary artery pressure-guided therapy in ambulatory patients with symptomatic heart failure: the CardioMEMS European Monitoring Study for Heart Failure (MEMS-HF)}, series = {European Journal of Heart Failure}, volume = {22}, journal = {European Journal of Heart Failure}, number = {10}, doi = {10.1002/ejhf.1943}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-218061}, pages = {1891 -- 1901}, year = {2020}, abstract = {Aims Heart failure (HF) leads to repeat hospitalisations and reduces the duration and quality of life. Pulmonary artery pressure (PAP)-guided HF management using the CardioMEMS™ HF system was shown to be safe and reduce HF hospitalisation (HFH) rates in New York Heart Association (NYHA) class III patients. However, these findings have not been replicated in health systems outside the United States. Therefore, the CardioMEMS European Monitoring Study for Heart Failure (MEMS-HF) evaluated the safety, feasibility, and performance of this device in Germany, The Netherlands, and Ireland. Methods and results A total of 234 NYHA class III patients (68 ± 11 years, 22\% female, ≥1 HFH in the preceding year) from 31 centres were implanted with a CardioMEMS sensor and underwent PAP-guided HF management. One-year rates of freedom from device- or system-related complications and from sensor failure (co-primary outcomes) were 98.3\% [95\% confidence interval (CI) 95.8-100.0] and 99.6\% (95\% CI 97.6-100.0), respectively. Survival rate was 86.2\%. For the 12 months post- vs. pre-implant, HFHs decreased by 62\% (0.60 vs. 1.55 events/patient-year; hazard ratio 0.38, 95\% CI 0.31-0.48; P < 0.0001). After 12 months, mean PAP decreased by 5.1 ± 7.4 mmHg, Kansas City Cardiomyopathy Questionnaire (KCCQ) overall/clinical summary scores increased from 47.0 ± 24.0/51.2 ± 24.8 to 60.5 ± 24.3/62.4 ± 24.1 (P < 0.0001), and the 9-item Patient Health Questionnaire sum score improved from 8.7 ± 5.9 to 6.3 ± 5.1 (P < 0.0001). Conclusion Haemodynamic-guided HF management proved feasible and safe in the health systems of Germany, The Netherlands, and Ireland. Physician-directed treatment modifications based on remotely obtained PAP values were associated with fewer HFH, sustainable PAP decreases, marked KCCQ improvements, and remission of depressive symptoms.}, language = {en} } @article{StoerkBernhardtBoehmetal.2022, author = {St{\"o}rk, Stefan and Bernhardt, Alexandra and B{\"o}hm, Michael and Brachmann, Johannes and Dagres, Nikolaos and Frantz, Stefan and Hindricks, Gerd and K{\"o}hler, Friedrich and Zeymer, Uwe and Rosenkranz, Stephan and Angermann, Christiane and Aßmus, Birgit}, title = {Pulmonary artery sensor system pressure monitoring to improve heart failure outcomes (PASSPORT-HF): rationale and design of the PASSPORT-HF multicenter randomized clinical trial}, series = {Clinical Research in Cardiology}, volume = {111}, journal = {Clinical Research in Cardiology}, number = {11}, doi = {10.1007/s00392-022-01987-3}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-324026}, pages = {1245-1255}, year = {2022}, abstract = {Background Remote monitoring of patients with New York Heart Association (NYHA) functional class III heart failure (HF) using daily transmission of pulmonary artery (PA) pressure values has shown a reduction in HF-related hospitalizations and improved quality of life in patients. Objectives PASSPORT-HF is a prospective, randomized, open, multicenter trial evaluating the effects of a hemodynamic-guided, HF nurse-led care approach using the CardioMEMS™ HF-System on clinical end points. Methods and results The PASSPORT-HF trial has been commissioned by the German Federal Joint Committee (G-BA) to ascertain the efficacy of PA pressure-guided remote care in the German health-care system. PASSPORT-HF includes adult HF patients in NYHA functional class III, who experienced an HF-related hospitalization within the last 12 months. Patients with reduced ejection fraction must be on stable guideline-directed pharmacotherapy. Patients will be randomized centrally 1:1 to implantation of a CardioMEMS™ sensor or control. All patients will receive post-discharge support facilitated by trained HF nurses providing structured telephone-based care. The trial will enroll 554 patients at about 50 study sites. The primary end point is a composite of the number of unplanned HF-related rehospitalizations or all-cause death after 12 months of follow-up, and all events will be adjudicated centrally. Secondary end points include device/system-related complications, components of the primary end point, days alive and out of hospital, disease-specific and generic health-related quality of life including their sub-scales, and laboratory parameters of organ damage and disease progression. Conclusions PASSPORT-HF will define the efficacy of implementing hemodynamic monitoring as a novel disease management tool in routine outpatient care. Trial registration ClinicalTrials.gov; NCT04398654, 13-MAY-2020.}, language = {en} }