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 November 15, at American Heart Association (AHA) Scientific Sessions 2017 and simultaneously published in the journal Circulation.

Sanjiv J. Shah, MD, FACC, et al., looked at 44 HF patients with preserved ejection fraction >=40% 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.