Heart failure & cardiomyopathies
Atrial Mechanics in Heart Failure With Preserved Ejection Fraction: Effect of a No-Implant Interatrial Shunt
Authors' conclusion
Hemodynamic and strain assessment in patients with heart failure with preserved ejection fraction suggests that a no-implant interatrial shunt can significantly improve the pressure-function relationship of the LA.
Study context
- Population
- Patients with NYHA class II, III or ambulatory IV HF, LVEF ≥40% and elevated left atrial (LA) wedge pressure during supine ergometry (≥25 mm Hg)
- Participants
- 33 patients
- Comparison
- Before vs after creation of a no-implant interatrial shunt
- Outcome
- LA pressure (at rest and during exercise), before vs after no-implant interatrial shunt
- Follow-up
- 1 month
Main finding
As reported in the abstract
| Group | LA pressure at rest | LA pressure during exercise |
|---|---|---|
| Baseline | 19.7±7.0 mm Hg | 39.7±10.5 mm Hg |
| 1 month | 17.2±5.0 mm Hg | 33.6±11.1 mm Hg |
LA pressure at rest
Baseline19.7±7.0 mm Hg
1 month17.2±5.0 mm Hg
LA pressure during exercise
Baseline39.7±10.5 mm Hg
1 month33.6±11.1 mm Hg
- 1 month vs Baseline: P = 0.044 — LA pressure at rest
- 1 month vs Baseline: P = 0.002 — LA pressure during exercise
- Mean decrease in LA work
- 55.4 mm Hg/W·kg (P<0.001)
Further findings
LA reservoir strain · 1 and 6 months
- Improvement at 1 month
- +4.0% (P=0.015)
- Improvement at 6 months
- +4.1% (P=0.046)
LA conduit and contractile strain; RA strain
- Modest improvements in LA conduit and contractile strain, similar trend in RA strain
Atrial volumes
- Significant reduction in LA volumes and increase in RA volume
RA pressure and RV function
- No change in RA pressure or measures of RV function
Original publication
Atrial Mechanics in Heart Failure With Preserved Ejection Fraction: Effect of a No-Implant Interatrial Shunt. Circ Heart Fail. Published 3 September 2025. doi:10.
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