title: Heart failure and respiratory hospitalizations are reduced in patients with heart failure and chronic obstructive pulmonary disease with the use of an implantable pulmonary artery pressure monitoring device.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) is a frequent comorbidity in patients with heart failure (HF). Elevated pulmonary arterial (PA) pressure can be seen in both conditions and has been shown to predict morbidity and mortality.
  
  
  RESULTS
  A total of 550 subjects with New York Heart Association functional class III HF were randomly assigned to the treatment (n = 270) and control (n = 280) groups in the CHAMPION Trial. Physicians had access to the PA pressure measurements in the treatment group only, in which HF therapy was used to lower the elevated pressures. HF and respiratory hospitalizations were compared in both groups. A total of 187 subjects met criteria for classification into the COPD subgroup. In the entire cohort, the treatment group had a 37% reduction in HF hospitalization rates (P < .0001) and a 49% reduction in respiratory hospitalization rates (P = .0061). In the COPD subgroup, the treatment group had a 41% reduction in HF hospitalization rates (P = .0009) and a 62% reduction in respiratory hospitalization rates (P = .0023). The rate of respiratory hospitalizations in subjects without COPD was not statistically different (P = .76).
  
  
  CONCLUSIONS
  HF management incorporating hemodynamic information from an implantable PA pressure monitor significantly reduces HF and respiratory hospitalizations in HF subjects with comorbid COPD compared with standard care.
authors.affiliation: Temple University School of Medicine, Philadelphia, Pennsylvania. Electronic address: jason.krahnke@tuhs.temple.edu.
authors.forename: Jason S
authors.initials: JS
authors.lastname: Krahnke
authors.affiliation: Ohio State University Heart and Vascular Center, Columbus, Ohio.
authors.forename: William T
authors.initials: WT
authors.lastname: Abraham
authors.affiliation: Oklahoma Heart Hospital and Oklahoma Foundation for Cardiovascular Research, Oklahoma City, Oklahoma.
authors.forename: Philip B
authors.initials: PB
authors.lastname: Adamson
authors.affiliation: University of Alabama, Birmingham, Alabama.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Bourge
authors.affiliation: St Jude Medical, Atlanta, Georgia.
authors.forename: Jordan
authors.initials: J
authors.lastname: Bauman
authors.affiliation: St Jude Medical, Atlanta, Georgia.
authors.forename: Greg
authors.initials: G
authors.lastname: Ginn
authors.affiliation: Weill Cornell Medical College, New York, New York.
authors.forename: Fernando J
authors.initials: FJ
authors.lastname: Martinez
authors.affiliation: Temple University School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Gerard J
authors.initials: GJ
authors.lastname: Criner
mesh_terms: D000368:Aged; D018660:Blood Pressure Monitoring, Ambulatory / Q000295:instrumentation* / Q000379:methods; D002407:Catheterization, Swan-Ganz / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology / Q000517:prevention & control*; D006760:Hospitalization / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019736:Prostheses and Implants; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D012120:Respiration Disorders / Q000175:diagnosis / Q000503:physiopathology / Q000517:prevention & control; D016037:Single-Blind Method
keywords: Heart failure; chronic obstructive pulmonary disease; hospitalization; implantable pulmonary artery pressure monitor