Limitations of Right Heart Catheterization in the Diagnosis and Risk Stratification of Patients with Pulmonary Hypertension: Insights from the CHAMPION Trial

Raina, Amresh; Bourge, Robert C.; Abraham, William T.; Adamson, Philip B.; Bauman, Janine; Yadav, Jatin; Benza, Raymond L.

doi:10.1016/j.healun.2014.01.281

Cited by 1 publication

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“…In patients with PH related to left heart disease in the CHAMPION trial, the baseline resting RHC significantly underestimated the prevalence of PH when compared to the average mean PA pressure from IHM data over the first week at home post implant. 18 In many centers and in the community, exercise hemodynamics are often not routinely performed in PAH patients, and even in those centers that do undertake rigorous exercise evaluation, the exercise protocol may not mirror the hemodynamic changes seen with daily activities.…”

Section: Assessment Of Borderline Ph or Exercise-induced Symptomsmentioning

confidence: 99%

“…28 Moreover, a recent substudy of the CHAMPION trial suggested that WHO Group II PH was underdiagnosed by a baseline RHC when compared to the mean PA pressure on IHM monitoring over the first week of the study, and that patients with occult PH had higher hospitalization rates than those without any PH. 18 Based on results of the CHAMPION trial, the CardioMEMS device has received FDA approval for the management of NYHA functional class III HF with HF hospitalization in the past year.…”

Section: Experience With Current Ambulatory Hemodynamic Monitoring Symentioning

confidence: 99%

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Ambulatory Hemodynamic Monitoring in the Management of Pulmonary Arterial Hypertension

Raina

Benza

2014

Advances in Pulmonary Hypertension

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Background: Pulmonary arterial hypertension (PAH) is characterized by pulmonary vascular remodeling, rise in pulmonary arterial pressures, and if left untreated, right heart failure. Invasive hemodynamic assessment with right heart catheterization (RHC) has been the gold standard for the diagnosis and serial assessment of patients with PAH. However, RHC has important limitations and might be supplemented by newer technologies in the management of PAH patients. Implications for Clinicians: Implantable hemodynamic monitors (IHM) hold the promise of being able to provide accurate pulmonary artery pressure measurements, with frequent or continuous remote monitoring in the home or ambulatory setting. As such, IHMs may provide a more complete understanding of a patient's hemodynamic profile and burden of disease. IHM data may also help to provide ongoing feedback in terms of a PAH patient's response to medical therapy and other interventions and might be valuable in specific subsets of patients with borderline or exercise-induced PAH. Conclusions: Though clinical studies using IHMs in PAH patients have been limited to small series and case reports, these devices hold a great deal of promise to supplement RHC in the management of PAH patients and warrant further investigation and clinical experience.

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Section: Assessment Of Borderline Ph or Exercise-induced Symptomsmentioning

confidence: 99%

Section: Experience With Current Ambulatory Hemodynamic Monitoring Symentioning

confidence: 99%

Ambulatory Hemodynamic Monitoring in the Management of Pulmonary Arterial Hypertension

Raina

Benza

2014

Advances in Pulmonary Hypertension

View full text Add to dashboard Cite

show abstract

Limitations of Right Heart Catheterization in the Diagnosis and Risk Stratification of Patients with Pulmonary Hypertension: Insights from the CHAMPION Trial

Cited by 1 publication

References 0 publications

Ambulatory Hemodynamic Monitoring in the Management of Pulmonary Arterial Hypertension

Ambulatory Hemodynamic Monitoring in the Management of Pulmonary Arterial Hypertension

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