CardioMEMS guided heart failure management in cardio-oncology patients: a tertiary care cancer center experience

Abstract

Aims: Cancer patients and survivors are at increased risk of developing heart failure (HF) and heart failure hospitalization (HFH). Yet, the utilization of wireless pulmonary artery pressure sensing devices (PAPSD), like CardioMEMS, in this group is limited. Objectives: We aimed to explore the utilization of CardioMEMS in managing HF among oncology patients. Methods: We conducted a single-center retrospective study reviewing consecutive patients implanted with the CardioMEMS device between November 11, 2015, and February 21, 2023. We analyzed the device's impact on pulmonary artery pressures and HFH using statistical methods including Cox regression models and correlation studies between NT-proBNP levels and hemodynamic parameters. Results: The study included 28 patients, with hypertension (78%) and hyperlipidemia (78%) as prevalent comorbidities. Most patients had heart failure with preserved ejection fraction (64%). Post-implantation, we observed a reduction in HFH and improvements in pulmonary artery pressures. Cox regression identified prior HFH and elevated pulmonary artery systolic (PAS) and diastolic pressures (PAD) as risk factors for repeat HFH (HR: 1.24, 1.04, 1.07, respectively). Biomarker analysis showed a moderate positive correlation between NT-proBNP and PAD, indicating that higher levels are associated with increased hospital admissions. The device was safe with no sensor failures reported. Conclusions: CardioMEMS shows potential in improving HF management in cancer patients, reducing HFH and enhancing pulmonary artery pressure profiles. These preliminary results advocate for further, larger-scale prospective studies to confirm the benefits and integrate CardioMEMS into cardio-oncology care.