Heart failure & cardiomyopathiesResearch article
Changes in Pulmonary Artery Pressure Following Initiation of Guideline-Directed Medical Therapies in Patients With Heart Failure: Insights From GUIDE-HF
- analysis of patients implanted with a pulmonary artery pressure (PAP) sensor as part of the GUIDE-HF study
Authors' conclusion
These results may inform the selection of pharmacological therapy to manage elevated filling pressures during hemodynamic-guided therapy.
Study context
- Population
- Patients with heart failure implanted with a wireless pulmonary artery pressure sensor (CardioMEMS, Abbott) who newly initiated a core heart failure (HF) therapy at least 30 days post-implant and continued it for at least 30 days, without changes in loop diuretics or other core HF therapiespatients in the study, subsets with new initiation included in this analysis · new angiotensin receptor-neprilysin inhibitor initiation 50 · new sodium-glucose co-transporter-2 inhibitor initiation 97 · new mineralocorticoid receptor antagonist initiation 112 · new β-blocker initiation 33
- Participants
- 2,358 patients
- Comparison
- PAP from 7 days pre-initiation vs the 7-day period following 30 days of newly initiated treatment with core HF therapies
- angiotensin receptor-neprilysin inhibitorn = 50
- sodium-glucose co-transporter-2 inhibitorn = 97
- mineralocorticoid receptor antagonistn = 112
- β-blockern = 33
Main finding
As reported in the abstract
Change in diastolic PAP · 7-day period following 30 days of treatment vs 7 days pre-initiation
angiotensin receptor-neprilysin inhibitor
−1.56
decrease · 95% CI −3.54–-0.40 · mm Hg
mineralocorticoid receptor antagonist
−1.15
decrease · 95% CI −1.82–-0.47 · mm Hg
Further findings
PAP after sodium-glucose co-transporter-2 inhibitor initiation
- No detectable change in PAP
PAP after β-blocker initiation
- Trend to higher PAP, differences not significant
Original publication
Changes in Pulmonary Artery Pressure Following Initiation of Guideline-Directed Medical Therapies in Patients With Heart Failure: Insights From GUIDE-HF. Circ Heart Fail. Published 28 May 2026. doi:10.1161/circheartfailure.125.013877
Summarised from the published abstract; every number is checked against it