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  Interatrial Shunt Promising for Heart Failure With Preserved Ejection Fraction

For patients with heart failure with preserved ejection fraction, implantation of an interatrial shunt device appeared to be safe and was associated with clinical and hemodynamic improvements sustained for 1 year, in a new clinical study.The 1-year results from the REDUCE LAP HF study was presented at the American Heart Association 2016 Scientific Sessions this week.

This study provides the longest experience with an interatrial shunt device specifically developed for the management of heart failure with preserved ejection fraction and provides additional longitudinal support for the safety and efficacy of this approach. The 12-month results were reassuring on safety and the efficacy looked promising but needs confirmation in a randomized trial. This device would have an enormous impact on patients with heart failure with preserved ejection faction if these results are confirmed and will challenge us to identify patients earlier in the disease process.

Left ventricular ejection fraction is preserved or near normal in at least half of all patients presenting with symptoms of heart failure, and a key pathological feature of this condition is elevated left atrial pressure particularly during physical activity, which is strongly related to symptoms and reduced survival. Following the failure of several drug treatments for such patients, a transcatheter transvenous interatrial shunt device (IASD, Corvia Medical) has been developed with the aim of reducing the elevated left atrial pressure, while avoiding excessive left-to-right shunting.