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Products, Systems and Opportunities in Heart Failure Management

265 pages   51 Exhibits   34 Company Profiles   April 2004   Report #C301

Press Release

This report is a thorough assessment of the current and emerging clinical practice, products and systems for the prevention, screening, diagnosis and management of heart failure. The report details the incidence and prevalence of heart failure, projecting the trend as a result of demographics, intervention or other changes to the population of patients. The report details the current approaches applied by physicians (primary care & cardiologists) and healthcare systems to heart failure. The report addresses clinician and system approaches, detailing the practices, products, and services in use and under development. Products addressed include monitoring, medicines/drugs and devices. The report provides a detailed review of heart failure programs in place through disease management companies, and hospital, home care and outpatient programs. The report details the status of research toward improving heart failure programs. The report details the market outlook for products in heart failure management encompassing diagnostics, monitoring products, drugs/medicines and devices.



Table of Contents



1.1       What is Heart Failure?

1.2       Use of Clinical Guidelines

1.3       What Caused the Heart Failure Epidemic?

1.4       Preventing Heart Failure

1.5       Managing Heart Failure

1.6       Specialist vs. General Cardiologist or Primary Care Physician

1.6.1          Treating Heart Failure       Sodium Restriction       Pharmacological Treatment of HF       Interventional Therapy       Surgical Treatment       Ventricular end-diastolic support: Dynamic cardiomyoplasty and CorCap/Acorn       Cardiomyoplasty       ACORN Device       Can Heart Failure Be Reversed or Cured?       ICD/Biventricular Pacemaker/ Cardiac Resynchronization Therapy     Beta-Blocker Therapy


2.1       Heart Failure Programs: Bridging the Gap in Patient Care

2.1.1          Third-Party Disease Management Services with Focus in Heart Failure

2.1.2          Hospital-Based Heart Failure Programs

2.1.3          Telehomecare       Remote Patient Monitoring

2.1.4          In-Home Patient Monitoring: Measurements, Tools and Methods Used       Changes in Patient Weight       Blood Pressure       Electrocardiogram (ECG/EKG)       Patient Self-Described Symptoms       Video Teleconferencing       Pulse Oximetry

2.2       Implementing a Home-Based Heart Failure Management Program

2.2.1          Reimbursement for Heart Failure Programs       Active Involvement of HFSA Leadership in the HF Disease Management Reimbursement Issue

2.3       2.3 Finding Future Opportunities in Heart Failure Patient Home Monitoring

2.4       Home-Based Heart Failure Monitoring Market



3.1       Medical Management of Heart Failure

3.1.1          Usage of Current Drugs       ACE Inhibitors       Beta-Blockers          Comparing Currently Used Beta-Blockers       Investigating Hypertension Drugs in Heart Failure          Angiotensin II Receptor Blockers          Reducing Mortality in Post-Acute Myocardial Infarction Heart Failure          Addressing Cost Concerns in Treating Hypertension          Increasing Efforts to Aggressively Manage Hypertension       Tracking the Use of Evidence-Based Guidelines in Heart Failure Management

3.1.2          New and Investigational Drugs for Heart Failure Management       Diuretic Agents       Inotropic Agents       Vasodilator Agents          Human B-type Natriuretic Peptide          Endothelin Receptor Antagonists       Vasopeptidase Inhibitors Inhibitors       Other Drugs Under Development          Selective Aldosterone Receptor Antagonists          Xanthine Oxidase Inhibitors

3.2       Interventional Therapies

3.2.1          Cardiac Resynchronization Therapy       How CRT Evolved       Current and Future Investigations of CRT Devices       CRT Products          Guidant          Medtronic       Market Considerations          Adoption and Reimbursement          Addition of CRT Technology to HFSA Practice Guidelines

3.2.2          Mechanical Diuresis in Decompensated Heart Failure       Ultrafiltration as an Alternative to Intravenous Diuretic Therapy          CHF Solutions and Ultrafiltration

3.2.3          Ventricular Assist Devices       Current Product Offerings          Left Ventricular Assist Devices as a Permanent or Destination Therapy          Cost and Reimbursement Issues       Future Products and Next-Generation Technologies          Seond-Generation VADs          Continuous Flow Technology          Next-Generation Centrifugal Flow Pumps          Early Development-Stage Technologies          Percutaneous Ventricular Assist Devices

3.2.4          External Counterpulsation       CardioMedics       CPC of America       Vasomedical       External Counterpulsation in Heart Failure

3.2.5          Sleep-Disordered Breathing       Treating Sleep-Disordered Breathing in Heart Failure Patients       Developments in Sleep-Disordered Breathing Diagnosis          Market Activities and Product Developments


4.1       Use of Patient Hemodynamics in Clinical Decisions

4.1.1          Applications for the Use of Non-Invasive Hemodynamic Measurements       Cardiovascular Disease and Heart Failure Risk Stratification       Hypertension Control       Relation to Cardiovascular Risk Factors in Healthy Young Adults (The Bogalusa

4.2       Methods Used in Capturing Hemodynamic Data Non-invasively

4.2.1          Electrical Impedance Cardiography       Direct Current Component of Bioimpedance

4.3       Current Products in Non-invasive Hemodynamic Monitoring

4.3.1          Intra-Cardiac Monitoring in Heart Failure

4.3.2          Non-Invasive Cardiac Output

4.4       Ambulatory Blood Pressure Monitoring

4.4.1          ABP Monitors       Alternatives to the Use of ABP Monitors

4.4.2          Clinical Applications for ABPM

4.4.3          White-Coat Hypertension       Determinations of Damage to the Heart from Hypertension       Missed Potential in White-Coat Hypertension

4.4.4          Predicting Kidney Damage in Diabetics

4.4.5          Price Erosion

4.4.6          Who Pays?

4.4.7          Who Will Care?

4.5       ABPM Market

4.5.1          Year-to-Year Projections

4.5.2          ABPM Market Drivers

4.5.3          Ambulatory Blood Pressure Monitoring Market       Reimbursement

4.5.4          Barriers to Use       Price Erosion

4.5.5          Market Potential for Use of ABPM in Diagnosed Diabetics

4.5.6          Other Emerging Applications of Note       Pregnancy       Elevated Ambulatory and Normal Office Blood Pressure       Market for WCH Application          Third-Party Service Model


5.1       Manufacturers Involved in Assessing Risk of and Managing Heart Failure

5.1.1          A&D Medical       Products

5.1.2          AtCor Medical Pty. Ltd.       Products

5.1.3          CardioDynamics International Corp.       Financial Information

5.1.4          CardioMEMS, Inc.

5.1.5          CVP Diagnostics

5.1.6          Data Sciences International       Financial Information

5.1.7          Guidant       Financial Information

5.1.8          Hemonix, Inc.

5.1.9          Hemo Sapiens, Inc.

5.1.10        Hypertension Diagnostics, Inc.     Financial Information

5.1.11        Medtronic     Cardiac Resynchronization Therapy     Intra-Cardiac Hemodynamic Monitoring     Financial Information

5.1.12        Noninvasive Technologies, LLC

5.1.13        Pulse Metric, Inc.

5.1.14        Remon Medical Technologies Ltd.     Financial Information

5.1.15        ROZINN Electronics, Inc.

5.1.16        Savacor

5.1.17        SORBA Medical Systems, Inc.

5.1.18        SunTech Medical Instruments

5.1.19        Transoma Medical

5.1.20        VivoMetrics, Inc.

5.2       Cardiovascular Disease Management Service Companies

5.2.1          Alere Medical, Inc.       Products and Services       Heart Failure Disease Management Activities       Financial Information

5.2.2          American Healthways, Inc.       Heart Failure Disease Management Activities       Financial Information

5.2.3          Cardiocom Multi-Disease Management       Products and Services       Heart Failure Disease Management Activities

5.2.4          CorSolutions Medical, Inc.

5.2.5          CyberCare, Inc.       Financial Information

5.2.6          Health Hero Network, Inc.       Products and Services       Heart Failure Disease Management Activities

5.2.7          HomMed, LLC       Products and Services       Financial Information

5.2.8          I-trax, Inc.       Financial Information

5.2.9          LifeMasters Supported SelfCare, Inc.       Heart Failure Disease Management Activities       Financial Information

5.2.10        Landacorp, Inc.     Financial Information

5.2.11        McKesson Health Solutions, LLC     Financial Information

5.2.12        Pfizer Health Solutions     Financial Information

5.2.13        Protocol Driven Healthcare, Inc.

5.2.14        QMed Interactive Heart Management     Financial Information

Appendix I:  Disease Management Company Listing


Appendix II:  Device & Pharmaceutical Company Listing



List of Exhibits


Exhibit 1-1:  American College of Cardiology and the American Heart Association Stages of Heart Failure

Exhibit 1-2:  Comparison of General Cardiologists and Heart Failure Specialists in Diagnosis, Initial Treatment and Management of Heart Failure

Exhibit 1-3:  Surgical Procedures to Treat Heart Failure (Cleveland Clinic)

Exhibit 2-1:  Methods and Assessment Tools Used by Selected Disease Management Providers

Exhibit 2-2:  Patientís Needs in Heart Failure Programs

Exhibit 2-3:  Heart Failure Patient Management at Home:  Programs and Methods

Exhibit 2-4:  Methods and Assessment Tools Used by Selected Disease Management Providers

Exhibit 2-5:  Selected Studies of Hospital-Based HF Management Programs

Exhibit 2-6:  Listing of Terms Used in Telehomecare

Exhibit 2-7:  In-Home Health Status Parameters Measured

Exhibit 2-8:  Heart Failure Home Monitoring, Forecast 2004-2008

Exhibit 3-1:  New York Heart Association Functional Classification

Exhibit 3-2:  Selected Currently Available Heart Failure Medications

Exhibit 3-3:  Completed Clinical Trials of ACE Inhibitor and Beta-Blocker Usage in Heart Failure

Exhibit 3-4:  Clinical Trials Impacting Hypertension, Heart Failure and Cardiovascular-Related Mortality

Exhibit 3-5:  Trials Tracking the Medical Management of Heart Failure

Exhibit 3-6:  New and Investigational Drugs for Heart Failure, by Physiologic Effect

Exhibit 3-7:  Diuretics Currently Under Development for Heart Failure

Exhibit 3-8:  Inotropic Agents Currently Under Development

Exhibit 3-9:  Vasodilators Currently Under Development for Heart Failure

Exhibit 3-10:  Other Drugs Under Development

Exhibit 3-11:  New York Heart Association Functional Classification

Exhibit 3-12:  Selected Completed Trials for Cardiac Resynchronization Therapy in Heart Failure

Exhibit 3-13:  Current Trials for Cardiac Resynchronization Therapy in Heart Failure

Exhibit 3-14:  Cardiac Resynchronization Devices in the U.S. Market

Exhibit 3-15:  Techniques of Hemofiltration

Exhibit 3-16:  Diuresis Performed with Intravenous Diuretic Therapy versus Ultrafiltration*

Exhibit 3-17:  Currently Marketed Ventricular Assist Devices in the U.S.

Exhibit 3-18:  Ventricular Assist Devices under Development

Exhibit 3-19:  Comparison of Products Used for External Counterpulsation

Exhibit 3-20:  Prevalence Estimates of Sleep-Disordered Breathing Among Key Cardiovascular Disease Groups

Exhibit 3-21:  Using Continuous Positive Airway Pressure Treatments in Heart Failure Patients

Exhibit 3-22:  New Developments in Diagnosis of Sleep Disordered Breathing

Exhibit 3-23:  Selected Developments in Sleep-Disordered Breathing Diagnostics

Exhibit 4-1:  Clinical Determinations Made with Non-Invasive Hemodynamic Monitoring Techniques/Devices

Exhibit 4-2:  Selected Studies using Hemodynamic Monitoring with Chronic Heart Failure Patients

Exhibit 4-3:  Methods Used in Invasive Measurement of Hemodynamic Parameters

Exhibit 4-4:  Technology Comparison:  Peripheral Artery Catheters versus Non-invasive Cardiac Output Monitors

Exhibit 4-5:  Selected Hemodynamic Measurements and their Usage

Exhibit 4-6:  Using Non-Invasive Hemodynamic Measurements within the Patient Management Continuum

Exhibit 4-7:  Using Non-Invasive Hemodynamics in Assessing Patient Risk and Determining Treatment

Exhibit 4-8:  Identifiable Causes of Hypertension

Exhibit 4-9:  Implications of Early Recognition of Heart Failure Risk

Exhibit 4-10:  Comparison of Pulmonary Artery Catheter and the VeriCor System

Exhibit 4-11:  Intra-cardiac Hemodynamic Monitoring Under Development for Heart Failure

Exhibit 4-12:  Blood Pressure and Hypertension:  Classifications, Types and Terms Used

Exhibit 4-13:  Selected Ambulatory Blood Pressure Monitors

Exhibit 4-14:  Hypertension Population Treated in the U.S.

Exhibit 4-15:  New Hypertension Patients Treated in the U.S.

Exhibit 4-16:  Ambulatory Blood Pressure Monitoring Market Projections, 2003-2007

Exhibit 4-17:  Drivers and Limiters of the Market for ABPM Devices




Products, Systems and Opportunities in Heart Failure Management
April 2004


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MedMarket Diligence Reports are produced through primary and secondary research. Data is gathered from published sources on products and technologies on the market and under development.  Clinicians and industry representatives are interviewed for their knowledge and insights on product development, market development, clinical practice and trends associated with the evolving use of technologies. Secondary data is used to corroborate and support assessments and projections.  Reports are written and researched by industry insiders, whose familiarity with the companies, industry dynamics and other marketplace specifics facilitate the research process and ensure high quality and thorough reports.


 Contact: Patrick Driscoll, (949) 859-3401.

Copyright © 2006 MedMarket Diligence, LLC. All rights reserved.
Revised: 02/16/11


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