Key result
Atrial shunt devices yield a ~1.9% mortality rate while improving NYHA, 6MWD, and KCCQ scores.
Why the study?
Limited data are available regarding the atrial shunt device in patients with heart failure, making definitive recommendations challenging.
Does the atrial shunt device (ASD) improve symptoms and is it safe in patients with heart failure?
Meta-Analysis (n=522)
Does the atrial shunt device (ASD) improve symptoms and is it safe in patients with heart failure?
Atrial shunt devices appear safe and provide significant symptom relief in heart failure patients, particularly those with reduced EF, elevated NT-proBNP, and without hypertension, diabetes, or atrial fibrillation.
Supports atrial shunt device use for symptom relief in heart failure; extends pooled safety and efficacy data beyond individual studies.
BACKGROUND: Limited data are available regarding the atrial shunt device (ASD), making it challenging to provide definitive recommendations for patients with heart failure (HF). We conducted a meta-regression analysis to identify individuals who may derive greater benefit from this device. METHODS: We conducted a search across PubMed, EMBASE, and Cochrane databases, including 8 studies for meta-analysis. Estimated endpoints were derived using random-effects proportional meta-analysis. Additionally, meta-regression analysis was performed to elucidate the potential impact of key covariates on these endpoints. RESULTS: A total of 522 patients were included. The pooled analysis revealed an estimated mortality rate of 1.9 % for patients who underwent ASD. Additionally, the proportion of patients who remained in NYHA III to IV was reduced to 22.5 %. Furthermore, there was an improvement of 35.1 meters in the 6-minute walk distance (6MWD) and a 16.2-point improvement in the KCCQ score. Meta-regression analysis indicated that NYHA III to IV status was found to be directly proportional to age (β= 2.799), hypertension (β= 0.782), diabetes (β= 0.951), and atrial fibrillation (β= 0.778). Hypertension and a high level of left ventricular ejection fraction (LVEF) were associated with less improvement in 6MWD and KCCQ score, whereas a higher NT-proBNP level was associated with better improvement in 6MWD and KCCQ score. CONCLUSIONS: ASD emerges as a safe choice for HF patients aiming to alleviate symptoms. Specifically, individuals with reduced EF or elevated NT-proBNP levels, and without concomitant hypertension, diabetes, or atrial fibrillation, appear to achieve more substantial symptom relief.
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Gao et al. (2025) conducted a meta-analysis in heart failure (n=522). atrial shunt device was evaluated on mortality rate. The atrial shunt device in heart failure patients demonstrated a 1.9% estimated mortality rate, with improvements in NYHA class, 6-minute walk distance, and KCCQ scores.
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