CardioMEMS: where we are and where can we go?

Pour-Ghaz, Issa; Hana, David; Raja, Joel; Ibebuogu, Uzoma N.; Khouzam, Rami N.

doi:10.21037/atm.2019.07.53

Cited by 25 publications

(17 citation statements)

References 41 publications

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“…Relevant data is being collected and analyzed in larger numbers with emerging data types forthcoming. Those include image data, wearable data, environmental data and data generated by cardiac monitors such as CardioMEMs [120]. And, the combination of multiple data types, either clinical and molecular data or multi-omic integration is becoming more common.…”

Section: Discussionmentioning

confidence: 99%

Big Data Approaches in Heart Failure Research

Lanzer

Leuschner

Kramann

et al. 2020

Curr Heart Fail Rep

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Purpose of Review The goal of this review is to summarize the state of big data analyses in the study of heart failure (HF). We discuss the use of big data in the HF space, focusing on “omics” and clinical data. We address some limitations of this data, as well as their future potential. Recent Findings Omics are providing insight into plasmal and myocardial molecular profiles in HF patients. The introduction of single cell and spatial technologies is a major advance that will reshape our understanding of cell heterogeneity and function as well as tissue architecture. Clinical data analysis focuses on HF phenotyping and prognostic modeling. Summary Big data approaches are increasingly common in HF research. The use of methods designed for big data, such as machine learning, may help elucidate the biology underlying HF. However, important challenges remain in the translation of this knowledge into improvements in clinical care.

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Section: Discussionmentioning

confidence: 99%

Big Data Approaches in Heart Failure Research

Lanzer

Leuschner

Kramann

et al. 2020

Curr Heart Fail Rep

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“…We did not include terms that would retrieve established guidance such as BNP‐guided or surveillance that cannot be practically applied in all HF patients such us invasive monitoring. 9 The full search strategy is outlined in the Supporting Information .…”

Section: Methodsmentioning

confidence: 99%

“…27 The included studies used BNP or N-terminal pro-brain natriuretic peptide to confirm HF diagnosis rather to guide HF treatment. Although CardioMEMS 9 was recently approved for guided treatment in HF patients and has been shown to be effective in reducing readmissions in HF patients 9 as well as a cost-effective monitoring method, 9,28,29 we did not include this in our review as CardioMEMS is an invasive technique, not broadly applicable to the majority of frail, elderly patients. Radhoe et al 30 conducted a review of invasive remote haemodynamic sensors that monitor haemodynamic changes in HF patients and showed that CardioMEMS was the most effective device.…”

Section: Interventionsmentioning

confidence: 99%

Use of novel non‐invasive techniques and biomarkers to guide outpatient management of fluid overload and reduce hospital readmission: systematic review and meta‐analysis

et al. 2021

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Aims Fluid congestion is a leading cause of hospital admission, readmission, and mortality in heart failure (HF). We performed a systematic review and meta-analysis to determine the effectiveness of an advanced fluid management programme (AFMP). The AFMP was defined as an intervention providing tailored diuretic therapy guided by intravascular volume assessment, in hospitalized patients or after discharge. The AFMP group was compared with patients who received standard care treatment. The aim of this systematic review and meta-analysis was to determine the effectiveness of an AFMP in improving patient outcomes. Methods and results A systematic review of randomized controlled trials, case-control studies, and crossover studies using the terms 'heart failure', 'fluid management', and 'readmission' was conducted in PubMed, CINAHL, and Scopus up until November 2020. Studies reporting the association of an AFMP on readmission and/or mortality were included in our metaanalyses. Risk of bias was assessed in non-randomized studies using the Newcastle-Ottawa Scale. From 232 retrieved studies, 12 were included in the data synthesis. The 6040 patients in the included studies had a mean age of 72 ± 4 years and mean left ventricular ejection fraction of 39 ± 8%, there were slightly more men (n = 3022) than women, and the follow-up period was a mean of 4.8 ± 3.1 months. Readmission data were available in 5362 patients; of these, 1629 were readmitted. Mortality data were available in 5787 patients; of these, 584 died. HF patients who had an AFMP in hospital and/or after discharge had lower odds of all-cause readmission (odds ratio-OR 0.64 [95% confidence interval-CI 0.44, 0.92], P = 0.02) with moderate heterogeneity (I 2 = 46.5) and lower odds of all-cause mortality (OR 0.82 [95% CI 0.69, 0.98], P = 0.03) with low heterogeneity (I 2 = 0). The use of an AFMP was equally effective in reducing readmission and mortality regardless of age and follow-up duration. Effective pre-discharge diuresis was associated with significantly lower readmission odds (OR 0.43 [95% CI 0.26, 0.71], P = 0.001) compared with a fluid management plan as part of post-discharge follow-up. Conclusions An effective AFMP is associated with improving readmission and mortality in HF. Our results encourage attainment of optimal volume status at discharge and prescription of optimal diuretic dose. Ongoing support to maintain euvolaemia and effective collaboration between healthcare teams, along with effective patient education and engagement, may help to reduce adverse outcomes in HF patients.

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“…Changes in PA pressure are detected by the sensor and transmitted to a home-monitoring device. The data are collected by the patient and transferred to the clinic for prompt analysis and adjustment of HF therapies accordingly [90]. The CardioMEMS HF Sensor Allows Monitoring of Pressures to Improve Outcomes in NYHA Functional Class III Heart Failure Patients (CHAMPION) trial has investigated the use of CardioMEMS sensor implanted in the PA. Five hundred and fifty HF patients with NYHA Class III and a previous admission for HF in the prior year were recruited.…”

Section: Pulmonary Artery Pressure Monitoringmentioning

confidence: 99%

In Search of Clinical Impact: Advanced Monitoring Technologies in Daily Heart Failure Care

Nachman

Rahamim

Kolben

et al. 2021

JCM

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Despite significant advances in the management of heart failure (HF), further improvement in the outcome of this chronic and progressive disease is still considered a major unmet need. Recurrent hospitalizations due to decompensated HF frequently occur, resulting in increased morbidity and mortality rates. Past attempts at early detection of clinical deterioration were mainly based on monitoring of signs and symptoms of HF exacerbation, which have mostly given disappointing results. Extensive research of the pathophysiology of HF decompensation has indicated that hemodynamic alterations start days prior to clinical manifestation. Novel technologies aim to monitor these minute hemodynamic changes, allowing time for therapeutic interventions to prevent hemodynamic derangement and HF exacerbation. The latest noticeable advancements include assessment of lung fluid volume, wearable devices with integrated sensors, and microelectromechanical systems-based implantable devices for continuous measurement of cardiac filling pressures. This manuscript will review the rationale for monitoring HF patients and discuss previous and ongoing attempts to develop clinically meaningful monitoring devices to improve daily HF health care, with particular emphasis on the recent advances and clinical trials relevant to this evolving field.

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CardioMEMS: where we are and where can we go?

Cited by 25 publications

References 41 publications

Big Data Approaches in Heart Failure Research

Big Data Approaches in Heart Failure Research

Use of novel non‐invasive techniques and biomarkers to guide outpatient management of fluid overload and reduce hospital readmission: systematic review and meta‐analysis

In Search of Clinical Impact: Advanced Monitoring Technologies in Daily Heart Failure Care

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