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Continuous heart monitoring to evaluate treatment effects in pulmonary hypertension
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  • Published on:
    Implantable Loop Recorder In Pulmonary Hypertension Patients: “Not All The Glitters Is Gold”
    • Tommaso Recchioni, Cardiology Resident Department of Clinical, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy
    • Other Contributors:
      • Alexandra Mihai, Cardiology Resident
      • Giovanna Manzi, Cardiologist

    Dear Editor,
    we have curiously read the prospective study conducted by Mads Ørbæk Andersen and colleagues evaluating treatment effects on heart rate variability (HRV), HR and physical activity, with the use of an implantable loop recorder (ILR) for continuous heart monitoring. The authors enrolled 27 patients with pulmonary arterial hypertension (PAH) and 14 patients with chronic thrombo-embolic pulmonary hypertension (CTEPH). The 15 (36.6%) patients needing treatment escalation were older and had higher NT-proBNP values, higher WHO-functional class, lower exercise tolerance and worse right ventricular function assessed by echocardiography and cardiac magnetic resonance compared to the other 26 patients. Moreover, the escalation group patients experienced a significant increase in HRV and physical activity, a significant decrease in HR nighttime and a parallel improvement in the three parameters included in the COMPERA 2.0 risk assessment compared to the non-escalation cohort [1].

    As already reported in the limitations of the paper, the small population including mixed pulmonary hypertension etiologies and the design of the study limit the strength and the generalizability of the results. However, it invites PAH specialists to make interesting speculations.

    1. The proposal to consider HRV as a biomarker of PAH treatment response or as a potential primary endpoint of clinical trials is questionable, since it seems to set aside the pivotal role of the ri...

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    Conflict of Interest:
    None declared.