Description

Heart failure (HF) is one of the most common, costly, and deadly diseases affecting humans. Health disparities persist whereby HF-related morbidity and mortality are greater in Black populations for a number of reasons yet to be fully understood. While the distribution of multiple negative social determinants of health (SDoH) certainly plays a key role, growing evidence further implicates an outsized adverse impact from environmental factors among urban dwelling populations. In this regard, a number of studies show that air pollutants adversely impact HF and its prognosis. As such, the investigators believe that air pollution is a form of environmental racism and a significant contributor to poor outcomes among HF patients in Detroit, including an unacceptably high rate of death or rehospitalization (22% based on Henry Ford Health [HFH] data for 2022) at 90-days post-discharge. To combat this problem, the investigators propose to test the effectiveness of portable air cleaners (PACs), an emerging therapeutic intervention, that the investigators hypothesize will reduce personal-level exposure to PM2.5 resulting in improved clinical outcomes for HF patients.

Patients will be enrolled at hospital discharge and randomly assigned to active PAC vs. sham PAC (a PAC without a HEPA filter inside it). Two PACs will be given to each patient to place in the home after discharge (one in bedroom and one in living space). The study will also provide one PM2.5 sensor for each participant home.

Follow-up in-person visits will be scheduled at 30 and 90- days after randomization and will be completed to draw blood for biomarkers, measure blood pressure, health status (Kansas City Cardiomyopathy Questionnaire, KCCQ), functional status (6 minute walk distance), and assess for occurrence of clinical events (i.e. re-hospitalization or death). The biomarkers include measures of heart failure disease activity (NTproBNP), inflammation (CRP) and cardiac injury (high sensitivity troponin).