Spring Alexander M, Scotti Andrea, Echarte-Morales Julio, Sturla Matteo, Assafin Manaf, Bonnet Guillaume, D'Angelo Lorenzo, Torrado Juan, Murthy Sandhya, Granada Juan F, Ho Edwin, Slipczuk Leandro, Jorde Ulrich P, Bartunek Jozef, Latib Azeem
Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
RHU Envisage, ANR-23-RHUS-0007, Bordeaux, France.
Struct Heart. 2025 Jul 19;9(8):100704. doi: 10.1016/j.shj.2025.100704. eCollection 2025 Aug.
Despite a plethora of pharmacological therapies for heart failure (HF), reducing the symptomatic burden in patients with advanced HF remains an unmet clinical need. Over the past decade, atrial shunting has emerged as a novel therapy for those with symptomatic HF despite optimal guideline-directed medical therapy. Initially thought of as a therapy reserved for those with diastolic HF, the field now spans the entire HF spectrum. In this review, we explore the physiology, devices, and trials that have shaped the field of atrial shunting. We detail how device-based interatrial shunts, no-implant interatrial shunts, and coronary sinus shunts aim to provide clinical benefit in specific patient populations and the limitations associated with their use.
尽管有大量用于治疗心力衰竭（HF）的药物疗法，但减轻晚期HF患者的症状负担仍是一项尚未满足的临床需求。在过去十年中，心房分流术已成为一种新型疗法，用于治疗尽管接受了最佳指南指导药物治疗但仍有症状的HF患者。最初，心房分流术被认为是一种仅适用于舒张性HF患者的疗法，如今该领域已涵盖了整个HF谱系。在本综述中，我们探讨了塑造心房分流术领域的生理学、装置和试验。我们详细介绍了基于装置的房间隔分流器、无植入房间隔分流器和冠状窦分流器如何旨在为特定患者群体提供临床益处以及与它们使用相关的局限性。
