Implantable monitor may help in managing diastolic heart failure

December 11, 2008

Philadelphia, 11 December 2008 - An implantable hemodynamic monitor (IHM) may help to guide medical treatment in a large subgroup of patients with heart failure--those with diastolic heart failure (DHF), reports a study in the December Journal of Cardiac Failure (http://www.onlinejcf.com/), published by Elsevier.

Led by Michael R. Zile, M.D., of Medical University of South Carolina, Charleston, the researchers analyzed data on DHF patients enrolled in a larger randomized trial evaluating the IHM for heart failure. The IHM is a surgically implanted device that continuously records data on heart function and other key variables. The data can then be downloaded for analysis by health care professionals, who can use it to make adjustments in medical therapy. The goal is to avoid sudden drops in heart function, called acute decompensation.

The main "COMPASS-HF" study included 274 patients with all types of heart failure. The original results showed that the risk of heart failure events was reduced by about 20 percent in patients treated with the IHM, although the difference was not statistically significant.

The new analysis focused on the subgroup of patients with DHF. In DHF, the heart still has normal pumping function (ejection fraction), but no longer relaxes sufficiently to fill with blood normally. In the COMPASS-HF study, 70 patients with DHF were randomly assigned to receive the IHM, while the rest were managed without the IHM.

As in the main study, DHF patients who received the IHM device had a 20 percent reduction in heart failure events, although the difference was not significant. A 29 percent reduction in the risk of hospitalization for heart failure was also nonsignificant.

The IHM did lead to some significant changes in patient management, including more frequent adjustments in the dose of diuretics--a key part of treatment for heart failure. As in the larger study, the IHM device was safe in DHF patients, with a low complication rate.

Patients with chronic heart failure need careful medical management to avoid episodes of acute decompensation. Few studies have focused on patients with DHF, even though they account for about half of all patients with heart failure.

Based on the new analysis, there is as yet no evidence that using the IHM device to guide treatment reduces the risk of decompensation and heart failure events in patients with DHF. The IHM does appear safe for patients with heart failure, with a very low risk of complications. In addition, DHF patients receiving the IHM device show a trend toward lower rates of heart failure events, including hospitalization related to heart failure.

"This is very important study and the trends make sense," comments Barry M. Massie, M.D., Editor-in-Chief of Journal of Cardiac Failure. "Worsening of HF leading to hospitalization, usually as a result of pulmonary congestion and rising blood pressure, is often more abrupt in patients with preserved ejection fraction. Hemodynamic monitoring may provide an early clue and facilitate relatively simple and effective interventions."
-end-
About Journal of Cardiac Failure

Journal of Cardiac Failure (http://www.onlinejcf.com/) publishes original, peer-reviewed communications of scientific excellence and review articles on clinical research, basic human studies, animal studies, and bench research with potential clinical applications to heart failure--pathogenesis, etiology, epidemiology, pathophysiological mechanisms, assessment, prevention, and treatment. Journal of Cardiac Failure is the official journal of the Heart Failure Society of America and the Japanese Heart Failure Society. It has an Impact Factor of 3.067 (the highest among journals with a heart failure focus and 19th among all cardiovascular journals) and an Immediacy Factor of 1.306, the 7th among all cardiovascular journals.

About the Heart Failure Society of America

The Heart Failure Society of America (HFSA) is a nonprofit educational organization, founded in 1994 as the first organized association of heart failure experts. Today HFSA has over 1,700 members and provides a forum for all those interested in heart function, heart failure research and patient care. The Society also serves as a resource for governmental agencies (FDA, NIH, NHLBI, CMS). Additional information on HFSA can be found at www.hfsa.org.

About Elsevier

Elsevier is a world-leading publisher of scientific, technical and medical information products and services. Working in partnership with the global science and health communities, Elsevier's 7,000 employees in over 70 offices worldwide publish more than 2,000 journals and 1,900 new books per year, in addition to offering a suite of innovative electronic products, such as ScienceDirect (http://www.sciencedirect.com/), MD Consult (http://www.mdconsult.com/), Scopus (http://www.info.scopus.com/), bibliographic databases, and online reference works.

Elsevier (http://www.elsevier.com/) is a global business headquartered in Amsterdam, The Netherlands and has offices worldwide. Elsevier is part of Reed Elsevier Group plc (http://www.reedelsevier.com/), a world-leading publisher and information provider. Operating in the science and medical, legal, education and business-to-business sectors, Reed Elsevier provides high-quality and flexible information solutions to users, with increasing emphasis on the Internet as a means of delivery. Reed Elsevier's ticker symbols are REN (Euronext Amsterdam), REL (London Stock Exchange), RUK and ENL (New York Stock Exchange).

Elsevier

Related Heart Failure Articles from Brightsurf:

Top Science Tip Sheet on heart failure, heart muscle cells, heart attack and atrial fibrillation results
Newly discovered pathway may have potential for treating heart failure - New research model helps predict heart muscle cells' impact on heart function after injury - New mass spectrometry approach generates libraries of glycans in human heart tissue - Understanding heart damage after heart attack and treatment may provide clues for prevention - Understanding atrial fibrillation's effects on heart cells may help find treatments - New research may lead to therapy for heart failure caused by ICI cancer medication

Machining the heart: New predictor for helping to beat chronic heart failure
Researchers from Kanazawa University have used machine learning to predict which classes of chronic heart failure patients are most likely to experience heart failure death, and which are most likely to develop an arrhythmic death or sudden cardiac death.

Heart attacks, heart failure, stroke: COVID-19's dangerous cardiovascular complications
A new guide from emergency medicine doctors details the potentially deadly cardiovascular complications COVID-19 can cause.

Autoimmunity-associated heart dilation tied to heart-failure risk in type 1 diabetes
In people with type 1 diabetes without known cardiovascular disease, the presence of autoantibodies against heart muscle proteins was associated with cardiac magnetic resonance (CMR) imaging evidence of increased volume of the left ventricle (the heart's main pumping chamber), increased muscle mass, and reduced pumping function (ejection fraction), features that are associated with higher risk of failure in the general population

Transcendental Meditation prevents abnormal enlargement of the heart, reduces chronic heart failure
A randomized controlled study recently published in the Hypertension issue of Ethnicity & Disease found the Transcendental Meditation (TM) technique helps prevent abnormal enlargement of the heart compared to health education (HE) controls.

Beta blocker use identified as hospitalization risk factor in 'stiff heart' heart failure
A new study links the use of beta-blockers to heart failure hospitalizations among those with the common 'stiff heart' heart failure subtype.

Type 2 diabetes may affect heart structure and increase complications and death among heart failure patients of Asian ethnicity
The combination of heart failure and Type 2 diabetes can lead to structural changes in the heart, poorer quality of life and increased risk of death, according to a multi-country study in Asia.

Preventive drug therapy may increase right-sided heart failure risk in patients who receive heart devices
Patients treated preemptively with drugs to reduce the risk of right-sided heart failure after heart device implantation may experience the opposite effect and develop heart failure and post-operative bleeding more often than patients not receiving the drugs.

How the enzyme lipoxygenase drives heart failure after heart attacks
Heart failure after a heart attack is a global epidemic leading to heart failure pathology.

Novel heart pump shows superior outcomes in advanced heart failure
Severely ill patients with advanced heart failure who received a novel heart pump -- the HeartMate 3 left ventricular assist device (LVAD) -- suffered significantly fewer strokes, pump-related blood clots and bleeding episodes after two years, compared with similar patients who received an older, more established pump, according to research presented at the American College of Cardiology's 68th Annual Scientific Session.

Read More: Heart Failure News and Heart Failure Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.