Alam Amit, Van Zyl Johanna, Nayyar Navdeep, Hall Shelley, Jermyn Rita
Baylor University Medical Center, Department of Advanced Heart Failure and Transplantation, Dallas, TX 75246, USA.
College of Medicine, Texas A&M University, Bryan, TX 77801, USA.
J Clin Med. 2021 Sep 22;10(19):4308. doi: 10.3390/jcm10194308.
Heart failure with preserved ejection fraction (HFpEF) patients often have other comorbidities, including obesity, dyslipidemia, hypertension, and diabetes, comprising the metabolic syndrome. The impacts of hemodynamic monitoring via CardioMEMS on these co-morbidities remain unknown.
A retrospective analysis of 29 patients with HFpEF (EF 45% or greater) and CardioMEMS was performed at a single center. Weight, body mass index (BMI), systolic blood pressures (SBP), high-density lipoprotein (HDL), triglycerides (TGL), hemoglobin A1C (HbA1c), and pulmonary artery diastolic pressures (PADP) were assessed at baseline and six months post-implant. Paired -tests and the Wilcoxon signed-rank test were used, as appropriate, to test differences between time points.
These patients were 69% female, with a mean age of 73 years, and 62% had non-ischaemic cardiomyopathies (NICM). At the time of CardioMEMS implantation, average PADP was 20.1 mmHg ± 5.7, weight was 102.6 kg ± 22.7, BMI was 38.0 kg/m ± 8.3, SBP was 135 mmHg ± 19, HDL was 42.4 mg/dL ± 11.3, and median TGL was 130 mg/dL (100, 180). At six months we witnessed a decrease by 20.9% in PADP to 15.9 mmHg ± 5.8, ( < 0.001). In addition, the following was noted: weight decreased by 2.5% to 100.0 kg ± 23.2, ( = 0.006), BMI reduced by 2.6% to 37.0 ± 8.2, ( = 0.002), SBP decreased by 6.7% to 126 mmHg ± 16 ( < 0.001), HDL increased by 10.8% to 47 mg/dL ± 11.9 ( < 0.001), and TGL decreased by 15.4% to 110 mg/dL (105, 135) ( = 0.001). 62% of patients were diabetic with no significant improvements in HbA1C values at the 6-month follow-up.
The utilization of CardioMEMS to optimize PADP results in an improvement in the comorbidities associated with the metabolic syndrome. Further studies are warranted to validate these findings and delineate clinical significance.
射血分数保留的心力衰竭（HFpEF）患者常伴有其他合并症，包括肥胖、血脂异常、高血压和糖尿病，这些构成了代谢综合征。通过CardioMEMS进行血流动力学监测对这些合并症的影响尚不清楚。
在单一中心对29例HFpEF（射血分数45%或更高）且植入CardioMEMS的患者进行回顾性分析。在基线和植入后6个月评估体重、体重指数（BMI）、收缩压（SBP）、高密度脂蛋白（HDL）、甘油三酯（TGL）、糖化血红蛋白（HbA1c）和肺动脉舒张压（PADP）。根据情况使用配对t检验和Wilcoxon符号秩检验来检验时间点之间的差异。
这些患者中69%为女性，平均年龄73岁，62%患有非缺血性心肌病（NICM）。在植入CardioMEMS时，平均PADP为20.1 mmHg±5.7，体重为102.6 kg±22.7，BMI为38.0 kg/m²±8.3，SBP为135 mmHg±19，HDL为42.4 mg/dL±11.3，TGL中位数为130 mg/dL（100，180）。在6个月时，我们观察到PADP下降了20.9%，降至15.9 mmHg±5.8，（P<0.001）。此外，还注意到以下情况：体重下降了2.5%，降至100.0 kg±23.2，（P=0.006），BMI降低了2.6%，降至37.0±8.2，（P=0.002），SBP下降了6.7%，降至126 mmHg±16（P<0.001），HDL升高了10.8%，至47 mg/dL±11.9（P<0.001），TGL下降了15.4%，至110 mg/dL（105，135）（P=0.001）。62%的患者患有糖尿病，在6个月随访时HbA1c值无显著改善。
利用CardioMEMS优化PADP可改善与代谢综合征相关的合并症。有必要进行进一步研究以验证这些发现并阐明其临床意义。
