Heart failure with reduced or preserved ejection fraction are both associated with elevated left atrial pressure at rest due to fluid overload or during exercise, leading to pulmonary venous congestion. Even with available treatments, heart failure hospitalizations remain high, and improvements in quality-of-life scores and functional capacity are modest. Thus, there is growing interest in non-pharmacological methods to decompress the left atrium and improve heart failure symptoms and outcomes. Left-to-right shunts have emerged as a potential therapeutic option to reduce left atrial hypertension, improve quality of life, and impact long-term outcomes. This nascent field carries both potential therapeutic promise as well as many unanswered questions. Recent data have questioned whether the effects of this therapy vary based on the left ventricular ejection fraction, pulmonary vascular resistance, and/or right ventricular structure and function. This review discusses the basis for left-to-right shunt therapies, synthesizes past and ongoing clinical trials, and offers future directions.
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http://dx.doi.org/10.1093/eurheartj/ehaf120 | DOI Listing |
Eur J Intern Med
March 2025
Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou of Guangdong, PR China. Electronic address:
Eur J Intern Med
March 2025
Department of Cardiology, Korea University Guro Hospital, Seoul, Republic of Korea.
Blood pressure variability; heart failure; Cardiovascular outcome; Diastolic blood pressure.
View Article and Find Full Text PDFAppl Nurs Res
April 2025
Training Office, IRCCS Policlinico San Donato, Milano, Italy.
Background: Self-care is essential for patient with chronic conditions such as heart failure. Self-care facilitates adaptation in patients with a Left Ventricular Assist Device (LVAD), improving their outcomes and preventing complications. Currently, no studies provide an overview of self-care in people with LVADs.
View Article and Find Full Text PDFOpen Heart
March 2025
Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
Background: Observational studies have reported that sleep is associated with the risk of major depressive disorder (MDD) and cardiovascular diseases (CVDs). However, the causal relationships among various sleep traits remain contentious, and whether MDD mediates the impact of specific sleep traits on CVDs is unclear.
Methods: We performed two-sample Mendelian randomisation analyses to explore whether insomnia, sleep time, daytime napping, daytime sleepiness, chronotype, snoring or obstructive sleep apnoea were causally associated with the risk of five CVDs, including coronary artery disease (CAD), myocardial infarction (MI), heart failure (HF), atrial fibrillation and stroke.
J Leukoc Biol
March 2025
Berlin Institute of Health at Charité - Universitätsmedizin Berlin, BIH Center for Regenerative Therapies (BCRT), Berlin, Germany.
Age is an important risk factor for cardiovascular diseases (CVD) and associated with a systemic, low-grade inflammation, so called "inflammaging". We aimed to investigate the impact of age and sex on the inflammatory markers S100A9 and components of the NLRP3 inflammasome at an early stage in the aging process, using mature adult and middle-aged/perimenopausal mice. Given the importance of the cardiosplenic axis in heart failure, the spleen was analyzed in addition to the left ventricle and cardiac fibroblasts.
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