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Novel approaches for left atrial pressure relief: Device-based monitoring and management in heart failure

The importance of the left atrium (LA) has been emphasized in recent years as the features of heart failure (HF), especially with regard to variability in patient and pathology phenotypes, continue to be uncovered. Of note, among the population with HF with preserved ejection fraction (HFpEF), press...

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Autores principales: Miyagi, Chihiro, Kuroda, Taiyo, Karimov, Jamshid H., Fukamachi, Kiyotaka
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9403239/
https://www.ncbi.nlm.nih.gov/pubmed/36035901
http://dx.doi.org/10.3389/fcvm.2022.910957
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author Miyagi, Chihiro
Kuroda, Taiyo
Karimov, Jamshid H.
Fukamachi, Kiyotaka
author_facet Miyagi, Chihiro
Kuroda, Taiyo
Karimov, Jamshid H.
Fukamachi, Kiyotaka
author_sort Miyagi, Chihiro
collection PubMed
description The importance of the left atrium (LA) has been emphasized in recent years as the features of heart failure (HF), especially with regard to variability in patient and pathology phenotypes, continue to be uncovered. Of note, among the population with HF with preserved ejection fraction (HFpEF), pressure or size of the LA have become a target for advanced monitoring and a therapeutic approach. In the case of diastolic dysfunction or pulmonary hypertension, which are often observed in patients with HFpEF, a conventional approach with clinical symptoms and physical signs of decompensation turned out to have a poor correlation with LA pressure. Therefore, to optimize HF treatment for these populations, several devices that are applied directly to the LA have been developed. First, two LA pressure (LAP) sensors (Heart POD and V-LAP Device) were developed and may enable patient self-management remotely with LAP-guided and physician-directed style. Second, there are device-based approaches that aim to decompress the LA directly. These include: (1) interatrial shunt devices; (2) left ventricular assist devices with LA cannulation; and (3) the left atrial assist device. While these novel device-based therapies are not yet commercially available, there is expected to be a rise in the proposition and adoption of a wider range of choices for monitoring or treating LA using device-based options, based on LA dimensional reduction and optimization of the clinically significant pressure relief. Further development and evaluation are necessary to establish a more favorable management strategy for HF.
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spelling pubmed-94032392022-08-26 Novel approaches for left atrial pressure relief: Device-based monitoring and management in heart failure Miyagi, Chihiro Kuroda, Taiyo Karimov, Jamshid H. Fukamachi, Kiyotaka Front Cardiovasc Med Cardiovascular Medicine The importance of the left atrium (LA) has been emphasized in recent years as the features of heart failure (HF), especially with regard to variability in patient and pathology phenotypes, continue to be uncovered. Of note, among the population with HF with preserved ejection fraction (HFpEF), pressure or size of the LA have become a target for advanced monitoring and a therapeutic approach. In the case of diastolic dysfunction or pulmonary hypertension, which are often observed in patients with HFpEF, a conventional approach with clinical symptoms and physical signs of decompensation turned out to have a poor correlation with LA pressure. Therefore, to optimize HF treatment for these populations, several devices that are applied directly to the LA have been developed. First, two LA pressure (LAP) sensors (Heart POD and V-LAP Device) were developed and may enable patient self-management remotely with LAP-guided and physician-directed style. Second, there are device-based approaches that aim to decompress the LA directly. These include: (1) interatrial shunt devices; (2) left ventricular assist devices with LA cannulation; and (3) the left atrial assist device. While these novel device-based therapies are not yet commercially available, there is expected to be a rise in the proposition and adoption of a wider range of choices for monitoring or treating LA using device-based options, based on LA dimensional reduction and optimization of the clinically significant pressure relief. Further development and evaluation are necessary to establish a more favorable management strategy for HF. Frontiers Media S.A. 2022-08-11 /pmc/articles/PMC9403239/ /pubmed/36035901 http://dx.doi.org/10.3389/fcvm.2022.910957 Text en Copyright © 2022 Miyagi, Kuroda, Karimov and Fukamachi. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Miyagi, Chihiro
Kuroda, Taiyo
Karimov, Jamshid H.
Fukamachi, Kiyotaka
Novel approaches for left atrial pressure relief: Device-based monitoring and management in heart failure
title Novel approaches for left atrial pressure relief: Device-based monitoring and management in heart failure
title_full Novel approaches for left atrial pressure relief: Device-based monitoring and management in heart failure
title_fullStr Novel approaches for left atrial pressure relief: Device-based monitoring and management in heart failure
title_full_unstemmed Novel approaches for left atrial pressure relief: Device-based monitoring and management in heart failure
title_short Novel approaches for left atrial pressure relief: Device-based monitoring and management in heart failure
title_sort novel approaches for left atrial pressure relief: device-based monitoring and management in heart failure
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9403239/
https://www.ncbi.nlm.nih.gov/pubmed/36035901
http://dx.doi.org/10.3389/fcvm.2022.910957
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