Managing the care of obese heart failure (HF) patients with pulmonary artery (PA) pressure monitoring can lead to reduced PA pressures, fewer HF hospitalizations and fewer all-cause hospitalizations, according to new data published in JACC: Heart Failure.
Researchers examined data from 1,200 patients who participated in the CardioMEMS Post Approval study. All patients presented with New York Heart Association functional class III HF symptoms and at least one HF hospitalization within 12 months of PA pressure sensor implantation. They were all treated from September 2014 to October 2017.
Fifty-six percent of the patients were female, and the mean patient age was 67 years old. More obese groups had elevated PA diastolic pressures at baseline.
The mean BMI was 31.7 kg/m2, and the overall prevalence of obesity of 52%.
The authors found that therapy guided by PA pressure was linked with a substantial and sustained drop in all PA pressure measurements over a 12-month period in both the higher and lower BMI cohort.
Furthermore, therapy led to big reductions in HF and all-cause hospitalization for all patients. Th effects were strikingly similar in groups with reduced and preserved ejection fraction.
“These results show that therapy guided by PA pressure is effective at reducing filling pressures in patients with class II to III obesity,” wrote D. Marshall Brinkley, MD, with the division of cardiovascular medicine at Vanderbilt University Medical Center in Nashville, and colleagues.
The authors also said that additional research is needed "to define the precise mechanisms by which obesity leads to the development of HF and to elucidate therapies for prevention."
"The best measure of obesity for cardiovascular risk also remains uncertain," they added.
Read the full study here.