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Related Concept Videos

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

398
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
398
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  11. Improvement Of Hemodynamics And Quality Of Life Before And After Interatrial Shunt Devices Implantation For Chronic Heart Failure: A Systematic Review And Meta-analysis

Improvement of Hemodynamics and Quality of Life Before and After Interatrial Shunt Devices Implantation for Chronic Heart Failure: A Systematic Review and Meta-analysis

Yugen Guan1, Lei Yang1, Yuwen Lu1

  • 1Department of Cardiology, Changhai Hospital Affiliated to Naval Medical University, Shanghai 200433, China.

Current Cardiology Reviews
|June 13, 2025

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View abstract on PubMed

Summary
This summary is machine-generated.

Transcatheter atrial septal shunt implantation improved quality of life and exercise capacity in heart failure patients. However, it did not significantly increase left ventricular ejection fraction in those with heart failure with reduced ejection fraction.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Heart Failure Management

Background:

  • Chronic heart failure (CHF) poses a significant burden on patients and healthcare systems.
  • Optimizing hemodynamic parameters and quality of life (QoL) are key goals in CHF management.
  • Atrial septal shunt implantation is an emerging therapeutic option for specific heart failure phenotypes.

Purpose of the Study:

  • To compare hemodynamic changes and quality of life before and after transcatheter atrial septal shunt implantation.
  • To evaluate the efficacy of atrial septal shunt implantation in different heart failure classifications.

Main Methods:

  • Systematic literature search in Cochrane Library, PubMed, and Embase up to September 2023.
  • Meta-analysis of 13 articles including 1026 participants with chronic heart failure.
Keywords:
Heart failurehemodynamicsinteratrial shunt devicesquality of life.

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  • Subgroup analysis based on heart failure with preserved (HFpEF), mildly reduced (HFmrEF), and reduced (HFrEF) ejection fraction.

    • Main Results:

    • Atrial septal shunt implantation led to decreased pulmonary capillary wedge pressure (PCWP) and increased right atrial pressure (RAP) and left ventricular ejection fraction (LVEF).
    • Significant improvements were observed in Minnesota Living with Heart Failure (MLWHF) scores, Kansas City Cardiomyopathy Questionnaire (KCCQ) scores, and 6-minute walking distance (6MWD).
    • In HFpEF/HFmrEF subgroups, LVEF and cardiac output (CO) increased, while PCWP decreased; however, no significant LVEF increase was noted in the HFrEF subgroup.

    Conclusions:

    • Transcatheter atrial septal shunt implantation improves hemodynamic parameters, exercise endurance, and QoL in patients with HFpEF and HFmrEF.
    • The procedure may not significantly enhance LVEF in patients with HFrEF.
    • Atrial septal shunt implantation represents a promising intervention for select heart failure populations.