{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T06:56:40Z","timestamp":1784357800952,"version":"3.55.0"},"reference-count":45,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,3,2]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Patients with recurring heart failure (HF) following cardiac resynchronization therapy fare poorly. Their management is undecided. We tested remote hemodynamic\u2010guided pharmacotherapy.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We evaluated cardiac resynchronization therapy subjects included in the CHAMPION (CardioMEMS Heart Sensor Allows Monitoring of Pressure to Improve Outcomes in New York Heart Association Class III Heart Failure Patients) trial, which randomized patients with persistent New York Heart Association Class III symptoms and \u22651 HF hospitalization in the previous 12\u00a0months to remotely managed pulmonary artery (PA) pressure\u2010guided management (treatment) or usual HF care (control). Diuretics and\/or vasodilators were adjusted conventionally in control and included remote PA pressure information in treatment. Annualized HF hospitalization rates, changes in PA pressures over time (analyzed by area under the curve), changes in medications, and quality of life (Minnesota Living with Heart Failure Questionnaire scores) were assessed. Patients who had cardiac resynchronization therapy (n=190, median implant duration 755\u00a0days) at enrollment had poor hemodynamic function (cardiac index 2.00\u00b10.59\u00a0L\/min per m\n              <jats:sup>2<\/jats:sup>\n              ), high comorbidity burden (67% had secondary pulmonary hypertension, 61% had estimated glomerular filtration rate &lt;60\u00a0mL\/min per 1.73\u00a0m\n              <jats:sup>2<\/jats:sup>\n              ), and poor Minnesota Living with Heart Failure Questionnaire scores (57\u00b124). During 18\u00a0months randomized follow\u2010up, HF hospitalizations were 30% lower in treatment (n=91, 62 events, 0.46 events\/patient\u2010year) versus control patients (n=99, 93 events, 0.68 events\/patient\u2010year) (hazard ratio, 0.70; 95% CI, 0.51\u20130.96;\n              <jats:italic>P<\/jats:italic>\n              =0.028). Treatment patients had more medication up\u2010\/down\u2010titrations (847 versus 346 in control,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), mean PA pressure reduction (area under the curve \u2212413.2\u00b1123.5 versus 60.1\u00b188.0 in control,\n              <jats:italic>P<\/jats:italic>\n              =0.002), and quality of life improvement (Minnesota Living with Heart Failure Questionnaire decreased \u221213.5\u00b123 versus \u22124.9\u00b124.8 in control,\n              <jats:italic>P<\/jats:italic>\n              =0.006).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Remote hemodynamic\u2010guided adjustment of medical therapies decreased PA pressures and the burden of HF symptoms and hospitalizations in patients with recurring Class III HF and hospitalizations, beyond the effect of cardiac resynchronization therapy.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT00531661.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.017619","type":"journal-article","created":{"date-parts":[[2021,2,25]],"date-time":"2021-02-25T10:00:13Z","timestamp":1614247213000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":24,"title":["Remote Hemodynamic\u2010Guided Therapy of Patients With Recurrent Heart Failure Following Cardiac Resynchronization Therapy"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2296-2596","authenticated-orcid":false,"given":"Niraj","family":"Varma","sequence":"first","affiliation":[{"name":"The Cleveland Clinic Foundation Cleveland OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9035-4133","authenticated-orcid":false,"given":"Robert C.","family":"Bourge","sequence":"additional","affiliation":[{"name":"University of Alabama Birmingham AL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8626-5258","authenticated-orcid":false,"given":"Lynne Warner","family":"Stevenson","sequence":"additional","affiliation":[{"name":"Vanderbilt University Nashville TN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Rosa","family":"Costanzo","sequence":"additional","affiliation":[{"name":"Advocate Heart Institute Chicago IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9209-9807","authenticated-orcid":false,"given":"David","family":"Shavelle","sequence":"additional","affiliation":[{"name":"University of Southern California Los Angeles CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip B.","family":"Adamson","sequence":"additional","affiliation":[{"name":"Abbott Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greg","family":"Ginn","sequence":"additional","affiliation":[{"name":"Abbott Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Henderson","sequence":"additional","affiliation":[{"name":"Abbott Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4805-1037","authenticated-orcid":false,"given":"William T.","family":"Abraham","sequence":"additional","affiliation":[{"name":"The Ohio State University Columbus OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the CHAMPION Investigator Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.101685"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.793273"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2013.11.025"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.09.043"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.117.004873"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.113.001281"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.04.024"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1080\/17434440.2017.1306438"},{"key":"e_1_3_1_10_2","article-title":"Optimized implementation of cardiac resynchronization therapy\u2014a call for action for referral and optimization of care","author":"Mullens W","year":"2020","unstructured":"Mullens W, Auricchio A, Martens P, Witte K, Cowie MR, Delgado V, Dickstein K, Linde C, Vernooy K, Leyva F, et al. 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