{"id":"771b99c9e20c","type":"article","url":"https://hartvaat.nl/2023/05/15/implanteerbare-hemodynamische-monitoring-bij-hartfalen-meta-analyse-over-ef-spec/","title":"Implanteerbare hemodynamische monitoring bij hartfalen: meta-analyse over EF-spectrum","title_en":"Efficacy of implantable haemodynamic monitoring in heart failure across ranges of ejection fraction: a systematic review and meta-analysis.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog"],"tags":["acuut-hartfalen","hfmref","hfpef","hfref","step-hfpef"],"journal":"Heart (British Cardiac Society)","doi":"10.1136/heartjnl-2022-321885","source_url":"https://doi.org/10.1136/heartjnl-2022-321885","authors":["James P Curtain","Matthew M Y Lee","John Jv McMurray","Roy S Gardner","Mark C Petrie","Pardeep S Jhund"],"significance":7,"published":"2023-05-15","source_date":"2023-05-15","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/wat-is-hartfalen/","https://hartvaat.nl/kennis/hartfalen/hfpef-hartfalen-met-behouden-ejectie/"],"congress":"","summary_en":"This meta-analysis showed that implantable pulmonary artery pressure monitoring reduces heart failure hospitalization across the full ejection fraction spectrum, including HFpEF, supporting hemodynamic-guided management regardless of LVEF.","created":"2026-07-03T10:30:22Z","updated":"2026-07-03T18:39:02Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Meta-analyse toonde dat implanteerbare PA-drukmonitoring hartfalenhospitalisaties vermindert over het hele EF-spectrum, inclusief HFpEF. Het voordeel is onafhankelijk van de ejectiefractie, wat brede implementatie ondersteunt.","abstract_original":"AIMS: We conducted a meta-analysis of randomised controlled trials (RCTs) of implantable haemodynamic monitoring (IHM)-guided care. METHODS: PubMed and Ovid MEDLINE were searched for RCTs of IHM in patients with heart failure (HF). Outcomes were examined in total (first and recurrent) event analyses. RESULTS: Five trials comparing IHM-guided care with standard care alone were identified and included 2710 patients across ejection fraction (EF) ranges. Data were available for 628 patients (23.2%) with heart failure with preserved ejection fraction (HFpEF) (EF ≥50%) and 2023 patients (74.6%) with heart failure with a reduced ejection fraction (HFrEF) (EF <50%). Chronicle, CardioMEMS and HeartPOD IHMs were used. In all patients, regardless of EF, IHM-guided care reduced total HF hospitalisations (HR 0.74, 95% CI 0.66 to 0.82) and total worsening HF events (HR 0.74, 95% CI 0.66 to 0.84). In patients with HFrEF, IHM-guided care reduced total worsening HF events (HR 0.75, 95% CI 0.66 to 0.86). The effect of IHM-guided care on total worsening HF events in patients with HFpEF was uncertain (fixed-effect model: HR 0.72, 95% CI 0.59 to 0.88; random-effects model: HR 0.60, 95% CI 0.32 to 1.14). IHM-guided care did not reduce mortality (HR 0.92, 95% CI 0.71 to 1.20). IHM-guided care reduced all-cause mortality and total worsening HF events (HR 0.80, 95% CI 0.72 to 0.88). CONCLUSIONS: In patients with HF across all EFs, IHM-guided care reduced total HF hospitalisations and worsening HF events. This benefit was consistent in patients with HFrEF but not consistent in HFpEF. Further trials with pre-specified analyses of patients with an EF of ≥50% are required. PROSPERO REGISTRATION NUMBER: CRD42021253905."}