De Lorenzo Leila Anna, Baratto Claudia, Sala Davide, Perego Giovanni Battista, Caravita Sergio
Università Vita E Salute San Raffaele, Milan, Italy.
Department of Cardiology, San Luca Hospital, IRCCS Istituto Auxologico Italiano, Milan, Italy.
Heart Fail Rev. 2025 Jan 25. doi: 10.1007/s10741-025-10485-3.
Left atrial (LA) hypertension is central in the pathophysiology of heart failure (HF) in general and of HF with preserved ejection fraction (HFpEF) in particular. Despite approved treatments, a number of HF patients continue experiencing disabling symptoms due to LA hypertension, causing pulmonary congestion, pulmonary hypertension, and right heart dysfunction, at rest and/or during exercise. LA decompression therapies, i.e., left atrial shunting through a specifically designed device (either implant-based or implant-free), are being studied in various forms of HF to alleviate LA hypertension and patients' symptoms. Despite a solid background and favorable signals from initial non-randomized clinical trials, the quest for the optimal HF candidate for interatrial shunt devices is still an area of active research that at the same time is helping to better elucidate the intricate pathophysiology of HF(pEF).
一般而言，左心房（LA）高血压是心力衰竭（HF）病理生理学的核心，尤其是射血分数保留的心力衰竭（HFpEF）。尽管有获批的治疗方法，但仍有许多HF患者因LA高血压持续出现致残症状，导致静息和/或运动时出现肺淤血、肺动脉高压和右心功能障碍。LA减压疗法，即通过专门设计的装置（基于植入物或无植入物）进行左心房分流，正在针对各种形式的HF进行研究，以减轻LA高血压和患者症状。尽管有坚实的背景和来自初始非随机临床试验的有利信号，但寻找心房分流装置的最佳HF候选者仍是一个活跃的研究领域，同时也有助于更好地阐明HF（pEF）复杂的病理生理学。
