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HOMEOSTASIS
Hemodynamically Guided Home Self-Therapy in Severe Heart Failure Patients
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Trial assessed effect of physician-directed self-management of left atrial pressure on outcomes and hemodynamics in patients with advanced HF.
Design: prospective, observational, first-in-human
Patients: 40
Centers: multicenter
Countries: Australia, New Zealand, United States
RESULTS: Survival was 61% at three years, with a decreased frequency in events reported after the first three months (HR=0.16; 95% CI, 0.04-0.68). The frequency of readings >25 mm Hg was decreased by 67% during the guided therapy (P<.001). Mean daily left atrial pressure decreased from 17.6 mm Hg (95% CI, 15.8-19.4) to 14.8 mm Hg (95% CI, 13.0-16.6) during the first three months of pressure-guided therapy. The frequency of left atrial pressure readings >20 mm Hg also decreased by 59% vs. the observation period (P<.001). Improvements in NYHA functional class (–0.7 ± 0.8; P<.001) and LVEF (7 ± 10%; P<.001) were also reported.
Published in: Circulation. 2010;121:1086-1095.
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