{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T01:33:01Z","timestamp":1781659981026,"version":"3.54.5"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2025,10]]},"abstract":"\n BACKGROUND:<\/jats:title>\n The atria play an important role in the pathophysiology of heart failure with preserved ejection fraction. Decreased left atrial strain is associated with worse clinical outcomes. The impact of no-implant interatrial shunting on atrial structure and function has not been described.<\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n We characterized the left atrial (LA) and right atrial strain-pressure relationship at rest and during exercise, before and after creation of a no-implant interatrial shunt. We included patients with New York Heart Association class II, III, or ambulatory IV heart failure with a left ventricular ejection fraction \u226540% and elevated LA wedge pressure during supine ergometry (\u226525 mm\u2009Hg). Exercise hemodynamics and echocardiographic measurements were analyzed at baseline, 1 month and 6 months (echo only) following transcatheter, transeptal creation of a 7 mm no-implant interatrial shunt.<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n \n A total of 33 patients were enrolled\/included in the study. At 1 month, LA pressure at rest was significantly reduced from 19.7\u00b17.0 to 17.2\u00b15.0 mm\u2009Hg (\n P<\/jats:italic>\n =0.044), and from 39.7\u00b110.5 to 33.6\u00b111.1 mm\u2009Hg (\n P<\/jats:italic>\n =0.002) during exercise. Reductions in LA pressure were associated with a mean decrease of 55.4 mm\u2009Hg\/W\u00b7kg in LA work (\n P<\/jats:italic>\n <0.001). Echo measurements demonstrated significant improvements in LA reservoir strain of +4.0% (\n P<\/jats:italic>\n =0.015) and +4.1% (\n P<\/jats:italic>\n =0.046) at 1 and 6 months, respectively. Modest improvements were observed in LA conduit and contractile strain, with a similar overall trend in right atrial strain measurements. These findings were associated with a significant reduction in LA volumes and an increase in right atrial volume. There was no change in right atrial pressure or measures of right ventricular function.\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n Hemodynamic and strain assessment in patients with heart failure with preserved ejection fraction suggests that a no-implant interatrial shunt can significantly improve the pressure-function relationship of the LA.<\/jats:p>\n <\/jats:sec>\n \n REGISTRATION:<\/jats:title>\n \n URL:\n https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n ; Unique identifiers: NCT04583527, NCT04838353, and NCT05501652.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/circheartfailure.124.012573","type":"journal-article","created":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T09:00:32Z","timestamp":1756890032000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Atrial Mechanics in Heart Failure With Preserved Ejection Fraction: Effect of a No-Implant Interatrial Shunt"],"prefix":"10.1161","volume":"18","clinical-trial-number":[{"clinical-trial-number":"nct05501652","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct04583527","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct04838353","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9105-2559","authenticated-orcid":true,"given":"Michal","family":"Laufer-Perl","sequence":"first","affiliation":[{"name":"Tel Aviv Sourasky Medical Center, Affiliated with the Gray School of Medicine, Tel Aviv University, Israel (M.L.-P., N.F., Y.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nir","family":"Flint","sequence":"additional","affiliation":[{"name":"Tel Aviv Sourasky Medical Center, Affiliated with the Gray School of Medicine, Tel Aviv University, Israel (M.L.-P., N.F., Y.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4258-6313","authenticated-orcid":true,"given":"Yaron","family":"Arbel","sequence":"additional","affiliation":[{"name":"Tel Aviv Sourasky Medical Center, Affiliated with the Gray School of Medicine, Tel Aviv University, Israel (M.L.-P., N.F., Y.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8171-2250","authenticated-orcid":true,"given":"Fawaz","family":"Alenezi","sequence":"additional","affiliation":[{"name":"Duke University, Durham, NC (F.A., V.K., M.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veraprapas","family":"Kittipibul","sequence":"additional","affiliation":[{"name":"Duke University, Durham, NC (F.A., V.K., M.F.)."},{"name":"Duke Clinical Research Institute, Durham, NC (V.K., M.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dmitry","family":"Yaranov","sequence":"additional","affiliation":[{"name":"Baptist Memorial Healthcare, Memphis, TN (D.Y.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamaz","family":"Shaburishvili","sequence":"additional","affiliation":[{"name":"Tbilisi Heart and Vascular Clinic, Georgia (T.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7304-7834","authenticated-orcid":true,"given":"Rohit","family":"Amin","sequence":"additional","affiliation":[{"name":"Ascension Sacred Heart Hospital, Pensacola, FL (R.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8671-7007","authenticated-orcid":true,"given":"Marat","family":"Fudim","sequence":"additional","affiliation":[{"name":"Duke University, Durham, NC (F.A., V.K., M.F.)."},{"name":"Duke Clinical Research Institute, Durham, NC (V.K., M.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.114.001276"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rec.2022.05.005"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.114.001667"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-51875-1"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1643"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1464"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00083.2022"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2011.02.026"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12872-017-0728-6"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.4250\/jcvi.2020.0142"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.117.003885"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2014.01.005"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2023.01.024"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2017.07.029"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/jum.14887"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/clc.23051"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/echo.15421"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.124.034249"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjimp\/qyae008"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.115.003754"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2021.02.013"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2024.0520"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.124.070870"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)00016-2"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.121.058592"}],"container-title":["Circulation: Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCHEARTFAILURE.124.012573","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T18:00:20Z","timestamp":1761069620000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCHEARTFAILURE.124.012573"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":25,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1161\/CIRCHEARTFAILURE.124.012573"],"URL":"https:\/\/doi.org\/10.1161\/circheartfailure.124.012573","relation":{},"ISSN":["1941-3289","1941-3297"],"issn-type":[{"value":"1941-3289","type":"print"},{"value":"1941-3297","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10]]},"assertion":[{"value":"2024-10-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}