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Transcatheter interatrial
shunt device (IASD)
Lancet. 2016 Mar 26
A transcatheter intracardiac shunt device for heart failure with preserved ejection fraction (REDUCE LAPHF): a multicentre, open-label, single-arm, phase 1 trial.
Hasenfuß G1, Hayward C2, Burkhoff D3, Silvestry FE4, McKenzie S5, Gustafsson F6, Malek F7, Van der
Heyden J8, Lang I9, Petrie MC10, Cleland JG11, Leon M12, Kaye DM13; REDUCE LAP-HF study investigators.
Heart failure:
• left ventricular systolic dysfunction (impairment in
ability of the heart to pump sufficient amounts of
blood into the circulation during systole)
• heart failure with preserved left ventricular ejection
fraction (HFPEF) or “diastolic” heart failure (patients
with normal left ventricular systolic function in whom
higher filling pressures are needed to obtain a normal
end‐diastolic volume of the left ventricle)1
Consequences:
Exercise inevitably produce an abrupt rise in pulmonary and left
atrial pressure, the main driver of dyspnoea in patients with heart
failure with preserved ejection fraction.3
Heart failure with preserved ejection fraction
(HFPEF) is a common, globally recognised, form of heart
failure for which no treatment has yet been shown to improve
symptoms or prognosis.2
Targets:
patients older than 40 years of age with symptoms of HFPEF
despite pharmacological therapy, left ventricular ejection fraction
higher than 40%, and a raised pulmonary capillary wedge pressure
at rest (>15 mm Hg) or during exercise (>25 mm Hg)2
Results:
In this open-label study of a novel transcatheter interatrial shunt device,
which was developed for the management of patients with HFPEF, we
recorded reductions in left atrial pressure during exercise with
improvements in functional capacity and quality of life 6 months after
implantation.2
References:
1. https://www.ncbi.nlm.nih.gov/pubmed/17699180
2.https://www.ncbi.nlm.nih.gov/pubmed/?term=A+transcatheter+intracardiac+shunt+device+for+heart+fa
ilure+with+preserved+ejection+fraction+(REDUCE+LAP-HF)%3A+a+multicentre%2C+openlabel%2C+single-arm%2C+phase+1+trial
3. https://www.ncbi.nlm.nih.gov/pubmed/27025419
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