Study Background and Disease Burden
Chronic heart failure (HF) remains a leading cause of morbidity and mortality globally, imposing significant health and economic burdens. Despite advances in pharmacological and device therapies, mortality rates remain high, particularly in patients hospitalized with worsening symptoms. Hemodynamically guided management through ambulatory monitoring of pulmonary artery (PA) pressures using implantable remote sensors has emerged as a promising strategy. Prior randomized trials demonstrated that reducing elevated PA pressures can lower mortality and hospitalization rates in patients with New York Heart Association (NYHA) class III HF. However, several fundamental questions remain unanswered: which PA pressure measurements (systolic, diastolic, or mean) most accurately predict all-cause mortality? Are these predictive across the spectrum of left ventricular ejection fractions (EFs), including both reduced (<50%) and preserved (≥50%) EF? Additionally, do temporal changes in PA pressure relate to subsequent survival outcomes? Addressing these questions can refine risk stratification and optimize therapeutic interventions in HF management.
