Department of Medical and Surgical Specialties, Radiological Sciences, ASST Spedali Civili Di Brescia, and Public Health University of Brescia, CardiologyBrescia, Italy.
Heart Fail Rev. 2023 Mar;28(2):315-330. doi: 10.1007/s10741-022-10280-4. Epub 2022 Nov 19.
Heart failure with preserved ejection fraction (HFpEF) accounts for more than half of heart failure hospital admissions in the last years and is burdened by high mortality and poor quality of life. Providing effective management for HFpEF patients is a major unmet clinical need. Increase in left atrial pressure is the key determinant of pulmonary congestion, with consequent dyspnoea and exercise limitation. Evidence on benefits of medical treatment in HFpEF patients is limited. Thus, alternative strategies, including devices able to reduce left atrial pressure, through an interatrial communication determining a left-right shunt, were developed. This review aims to summarize evidence regarding the use of percutaneous interatrial shunting devices. These devices are safe and effective in improving hemodynamic and clinical parameters, including pulmonary capillary wedge pressure, 6-min walking distance, and New York Heart Association functional class. Data on cardiovascular mortality and re-hospitalization for heart failure are still scarce.
射血分数保留的心力衰竭（HFpEF）占近年来心力衰竭住院患者的一半以上，其死亡率高，生活质量差。为 HFpEF 患者提供有效的治疗管理是一个主要的未满足的临床需求。左心房压力的增加是肺充血的关键决定因素，随之而来的是呼吸困难和运动受限。HFpEF 患者的药物治疗益处的证据有限。因此，开发了替代策略，包括能够通过导致左右分流的房间隔沟通来降低左心房压力的设备。本综述旨在总结经皮房间隔分流装置使用的证据。这些设备在改善血液动力学和临床参数方面是安全有效的，包括肺毛细血管楔压、6 分钟步行距离和纽约心脏协会功能分级。关于心血管死亡率和心力衰竭再入院的数据仍然很少。
