Physician-directed patient self-management in heart failure using left atrial pressure : Interim insights from the VECTOR-HF I and IIa studies
Meerkin, D. (Shaare Zedek Medical Center (Jerusalem, Israel))
Perl, L. (Tel Aviv University)
Hasin, T. (Hebrew University)
Petriashvili, S. (Aladashvili Clinic)
Kurashvili, L. (TIM)
Metreveli, M. (Jerarsi Clinic (Tbilissi, Geòrgia))
Ince, H. (Rostock University)
Feickert, S. (Rostock University)
Habib, M. (Technion Medical School Haifa)
Caspi, O. (Technion Medical School Haifa)
Jonas, M. (University School of Medicine)
Amat-Santos, I.J. (Hospital Clínico Universitario de Valladolid)
Bayés-Genís, Antoni (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Codina, Pau (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Koren, O. (Tel Aviv University)
Frydman, S. (Sourasky Medical Center)
Pachino, R.M. (Interventional Concepts)
Anker, Stefan (Charité-Universitätsmedizin Berlin)
Abraham, W.T. (Division of Cardiovascular Medicine. The Ohio State University)

Fecha:	2024
Resumen:	Aims: Haemodynamic monitoring using implantable pressure sensors reduces the risk of heart failure (HF) hospitalizations. Patient self-management (PSM) of haemodynamics in HF has the potential to personalize treatment, increase adherence, and reduce the risk of worsening HF, while lowering clinicians' burden. Methods and results: The VECTOR-HF I and IIa studies are prospective, single-arm, open-label clinical trials assessing safety, usability and performance of left atrial pressure (LAP)-guided HF management using PSM in New York Heart Association class II and III HF patients. Physician-prescribed LAP thresholds trigger patient self-adjustment of diuretics. Primary endpoints include the ability to perform LAP measurements and transmit data to the healthcare provider (HCP) interface and the patient guidance application, and safety outcomes. This is an interim analysis of 13 patients using the PSM approach. Over 12 months, no procedure- or device-related major adverse cardiovascular or neurological events were observed, and there were no failures to obtain measurements from the sensor and transmit the data to the HCP interface and the patient guidance application. Patient adherence was 91. 4%. Using PSM, annualized HF hospitalization rate significantly decreased compared to a similar period prior to PSM utilization (0 admissions vs. 0. 69 admissions over 11. 84 months, p = 0. 004). At 6 months, 6-min walk test distance and the Kansas City Cardiomyopathy Questionnaire overall summary score demonstrated significant improvement. Conclusions: Interim findings suggest that PSM using a LAP monitoring system is feasible and safe. PSM is associated with high patient adherence, potentially improving HF patients' functional status, quality of life, and limiting HF hospitalizations.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Heart failure ; Left atrial pressure monitoring ; Physician-directed patient self-management
Publicado en:	European Journal of Heart Failure, Vol. 26 Núm. 8 (august 2024) , p. 1814-1823, ISSN 1879-0844

DOI: 10.1002/ejhf.3338
PMID: 38899626

10 p, 1.7 MB

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Documentos de investigación > Documentos de los grupos de investigación de la UAB > Centros y grupos de investigación (producción científica) > Ciencias de la salud y biociencias > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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