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Am J Cardiol. 2019 Dec 15;124(12):1912-1917. doi: 10.1016/j.amjcard.2019.09.019. Epub 2019 Sep 26.

Assessment of Predictors of Left Atrial Volume Response to a Transcatheter InterAtrial Shunt Device (from the REDUCE LAP-HF Trial).

Author information

1
Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: thomas.hanff@pennmedicine.upenn.edu.
2
Alfred Hospital and Baker Heart and Diabetes Institute Melbourne, Victoria, Australia.
3
St. Vincent's Hospital, Sydney, New South Wales, Australia.
4
St. Antonius Hospital, Nieuwegein, The Netherlands.
5
Na Homolce Hospital, Prague, Czech Republic.
6
Heart Centre, Georg-August University, Gottingen, Germany.
7
Department of Cardiology, Rigshospitalet, Copenhagen, Denmark.
8
Cardiovascular Research Foundation, New York, New York.
9
Northwestern University Feinberg School of Medicine, Chicago, Illinois.
10
Medical University of South Carolina, Charleston, South Carolina.
11
Ohio State University Wexner Medical Center, Columbus, Ohio.
12
University of Michigan and VA Ann Arbor Healthcare System, Ann Arbor, Michigan.
13
Mayo Clinic College of Medicine, Rochester, Minnesota.
14
Brigham and Women's Hospital, Boston, Massachusetts.
15
Duke-National University of Singapore, Singapore.
16
Corvia Medical, Boston, Massachusetts.
17
Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.

Abstract

In patients with heart failure and preserved or mildly reduced ejection fractions (EF ≥40%), implantation of an interatrial shunt device (IASD) resulted in heterogenous changes of the left atrial (LA) volume. Baseline characteristics that correlate with a favorable decrease in LA volume are unknown. We hypothesized that a larger ratio of left to right atrial volume at baseline would correlate strongly with LA volume decongestion following IASD implantation. Reduce Elevated LA Pressure in Patients With Heart Failure was a multicenter study of the safety and feasibility of IASD implantation. Sixty-four patients with EF ≥40% underwent device implantation along with baseline conventional echocardiograms, speckle tracking echocardiography, and resting and exercise hemodynamics. Higher LA compliance (-4.2%, p = 0.048) and right atrial reservoir strain (-0.8%, p = 0.005) were independently associated with a percent decrease in the systolic LA volume index from baseline to 6-months. In conclusion, greater LA volume reduction following IASD implantation is associated with higher baseline compliance of the left atrium and higher reservoir strain of the right atrium.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT01913613.

PMID:
31653352
DOI:
10.1016/j.amjcard.2019.09.019
[Indexed for MEDLINE]

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