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CHAMPION: Hemodynamically guided HF management reduced hospitalization rates
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Hemodynamically guided HF management was associated with approximately 50% fewer hospitalizations than standard HF management, according to findings from the CHAMPION trial.
The prospective, single-blinded, randomized controlled trial was conducted to determine treatment options for 550 patients with HF and preserved ejection fraction. Specifically, the researchers aimed to test the hypothesis that hemodynamically guided management of HF can decrease decompensation that results in hospitalization.
The analysis included 119 patients with left ventricular ejection fraction (LVEF) ≥40% (mean, 50.6%), 430 patients with LVEF <40% (mean, 23.3%) and one patient with undocumented LVEF. All patients underwent catheter-based implantation of a microelectromechanical systems pressure sensor (CardioMEMS, St. Jude Medical) during right heart catheterization. Patients were then randomly assigned in a single-blind fashion to the treatment or control group.
Treatment involved daily uploaded pressures that were used for HF management, while controls underwent standard HF management with weight monitoring. Pressures were uploaded for controls but not used by the investigators.
The rate of HF hospitalization during 6 months for patients with preserved ejection fraction served as the primary outcome measure.
Patients in the treatment group experienced a 46% lower rate of the primary endpoint compared with controls (95% CI, 0.38-0.70; P<.0001).
The follow-up duration lasted an average of 17.6 months. During that period, hospitalization among patients in the treatment arm was 50% lower than in the control arm (95% CI, 0.35-0.70; P<.0001).
Patients in the treatment group also required more changes in diuretic and vasodilator therapies as a response to pulmonary artery pressure information.
“Hemodynamically-guided management of HF patients with preserved ejection fraction reduced decompensation leading to hospitalization compared to standard HF management strategies,” the researchers concluded, adding that the CHAMPION trial was the first hemodynamic monitoring trial to provide a protocol-directed treatment strategy to actively lower elevated pulmonary artery pressures using specific guidelines for diuretic and vasodilator therapy.
Disclosure: The researchers report financial disclosures with CardioMEMS.
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