In patients with heart failure (HF), treatment with an interatrial shunt device may reduce pulmonary capillary wedge pressure during exercise, according to results from the REDUCE LAP-HF trial presented Nov. 15 at AHA 2017 in Anaheim, CA, and simultaneously published in Circulation.

Sanjiv J. Shah, MD, FACC, et al., looked at 44 HF patients with preserved ejection fraction ≥40 percent with exercise pulmonary capillary wedge pressure ≥25 mmHg. Patients were randomized to receive an interatrial shunt device to lower left arterial pressure or a sham procedure.

Results showed that at one month, the interatrial shunt device resulted in "a greater reduction in pulmonary capillary wedge pressure" vs. the sham procedure (P=0.028 accounting for all stages of exercise). In addition, peak pulmonary capillary wedge pressure decreased by 3.5±6.4 mmHg in the interatrial shunt device group vs. 0.5±5.0 mmHg in the sham procedure group (p=0.14).

The authors conclude that moving forward, "further investigation in a large-scale pivotal randomized, sham-controlled clinical trial" of the interatrial shunt device in HF patients with preserved ejection fraction is warranted.

Keywords: AHA17, AHA Annual Scientific Sessions, Heart Failure, Prostheses and Implants, Stroke Volume

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