Heart Failure Clinical Trial
Official title:
Evaluation of Clinical Impact of Non-Invasive Hemodynamic Monitoring to Optimize Preventative Care of Heart Failure Patients
Study Details
What is the study design? (eg, randomized, double-blind) Observational Prospective Study
What are the overall objectives of the study? This project is designed to assess the
feasibility of using a non-invasive hemodynamic monitoring device in heart failure outpatient
clinics. There will be no alteration to patient management for this study. Rather this study
seeks to assess the utility of the device by evaluating for the parameters obtained from the
device to hospital admission.
How your research will contribute to the advancement of scientific knowledge?
☒This study will confirm/strengthen existing knowledge. ☒This study will test a completely
novel hypothesis. ☒This study will explore novel endpoints. ☐Other [please describe]:
B. BACKGROUND:
Nearly five million Americans experience heart failure (HF) and greater than 250,000 die
annually. 1 The prevalence has continued to increase with the aging of the US population and
HF is now the leading cause of hospitalization among adults >65 in the United states. Despite
remarkable improvements in medical therapy, the prognosis of patients with myocardial failure
remains poor, with almost 20% of patients dying within 1 year of initial diagnosis and > 80%
8-year mortality. 2 In addition patients who are admitted to the hospital for heart failure
have over a 50% readmission rate within six months of discharge. 3,4 These patients require
routine clinical care and often require diagnostic and therapeutic procedures. This project
seeks to assess if the use of hemodynamic (HD) monitoring technologies (ClearSight/Nexfin)
that are currently used in the intraoperative and critical care settings can provide utility
by demonstrating associations between alterations in a patients HD values to the likelihood
of hospital admission.
The non-invasive HD device utilized (Nexfin, Edwards Lifesciences, Irvine, CA) provided
flow-guided cardiovascular parameters that were captured for each clinic visit for up to 24
months. Analysis was performed between the most recent prior clinic visits for patients who
were hospitalized for HF exacerbation to those who were not hospitalized. HD data was not
used to guide clinical care. A Cox hazard model using a log transformation of HD variables as
the covariates, was applied to describe hospital admission.
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