Unloading left atrial hypertension by catheter-based, transvenous creation of atrial shunts is being explored to treat heart failure. So far, trials including sham control have demonstrated safety and efficacy in lowering left-sided cardiac filling pressures. Ongoing trials will determine the effect on clinical outcomes.
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References
Kaye, D. et al. Effects of an interatrial shunt on rest and exercise hemodynamics: results of a computer simulation in heart failure. J. Card. Fail. 20, 212–221 (2014).
Obokata, M. et al. Effects of interatrial shunt on pulmonary vascular function in heart failure with preserved ejection fraction. J. Am. Coll. Cardiol. 74, 2539–2550 (2019).
Søndergaard, L. et al. Transcatheter treatment of heart failure with preserved or mildly reduced ejection fraction using a novel interatrial implant to lower left atrial pressure. Eur. J. Heart Fail. 16, 796–801 (2014).
Hasenfuß, G. et al. A transcatheter intracardiac shunt device for heart failure with preserved ejection fraction (REDUCE LAP-HF): a multicentre, open-label, single-arm, phase 1 trial. Lancet 387, 1298–1304 (2016).
Shah, S. J. et al. One-year safety and clinical outcomes of a transcatheter interatrial shunt device for the treatment of heart failure with preserved ejection fraction in the reduce elevated left atrial pressure in patients with heart failure (REDUCE LAP-HF I) trial: a randomized clinical trial. JAMA Cardiol. 3, 968–977 (2018).
Shah, S. J. et al. Atrial shunt device for heart failure with preserved and mildly reduced ejection fraction (REDUCE LAP-HF II): a randomised, multicentre, blinded, sham-controlled trial. Lancet 399, 1130–1140 (2022).
Borlaug, B. A. et al. Latent pulmonary vascular disease may alter the response to therapeutic atrial shunt device in heart failure. Circulation 145, 1592–1604 (2022).
Paitazoglou, C. et al. One-year results of the first-in-man study investigating the Atrial Flow Regulator for left atrial shunting in symptomatic heart failure patients: the PRELIEVE study. Eur. J. Heart Fail. 23, 800–810 (2021).
Rodés-Cabau, J. et al. Interatrial shunting for heart failure: early and late results from the first-in-human experience with the V-Wave system. JACC Cardiovasc. Interv. 11, 2300–2310 (2018).
Udelson, J. E. et al. No-implant interatrial shunt for HFpEF: six-month outcomes from multicenter pilot feasibility studies. JACC Heart Fail. https://doi.org/10.1016/j.jchf.2023.01.024 (2023).
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F.G. has been an unpaid advisor to Corvia and an investigator in the REDUCE LAP-HF II trial. F.G. is also an advisor to Abbott, AdjuCor, Alnylam, AstraZeneca, Bayer, FineHeart, Ionis and Pfizer, and a speaker for Novartis.
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Gustafsson, F. Interatrial shunt devices for heart failure. Nat Rev Cardiol 20, 717–718 (2023). https://doi.org/10.1038/s41569-023-00923-w
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DOI: https://doi.org/10.1038/s41569-023-00923-w