The progress and implications of interatrial shunt
10.3969/j.issn.1004-8812.2024.08.008
- VernacularTitle:心房分流术研究进展及启示
- Author:
San-Shuai CHANG
1
;
Xin-Min LIU
;
Zheng-Ming JIANG
;
Wei MA
;
Jian-Zeng DONG
;
Guang-Yuan SONG
Author Information
1. 首都医科大学附属北京安贞医院心脏瓣膜病介入中心国家心血管病临床医学研究中心,北京 100029
- Keywords:
Heart failure;
Inter-atrial shunt;
Left atrial pressure;
Pulmonary capillary wedge pressure;
Pulmonary artery pressure
- From:
Chinese Journal of Interventional Cardiology
2024;32(8):463-467
- CountryChina
- Language:Chinese
-
Abstract:
Despite significant advancements in treatments for heart failure,the overall prognosis for patients remains poor.Hemodynamic abnormalities in heart failure manifest as elevated left atrial pressure and pulmonary congestion.Previous studies have shown that reducing left atrial pressure can improve symptoms and prognosis for heart failure patients,suggesting that left-sided heart overload may be a potential target for heart failure treatment.Atrial shunting procedures aim to create a stable and controlled left-to-right intracardiac shunt,restoring the decompensated left heart volume and pressure load in heart failure patients to a compensatory state,thereby improving heart failure symptoms and prognosis.Currently,this treatment is still in the clinical research stage globally.Existing data indicate that atrial shunting procedures can lower left atrial pressure at rest or during exercise in heart failure patients,improve pulmonary congestion,enhance patients'exercise tolerance,and clinical cardiac function.However,no studies have yet confirmed that it can improve clinical endpoints such as rehospitalization and mortality due to heart failure.Future research will focus on identifying heart failure patients who may benefit from atrial shunting,with assessments of heart failure etiology,right heart function,and reversibility of pulmonary vascular resistance,as well as heart failure classification based on ejection fraction,serving as potential key factors for patient selection.
