{"title":"慢性心力衰竭患者心房分流器植入前后血流动力学和生活质量的改善：系统回顾和荟萃分析","authors":"Yugen Guan, Lei Yang, Yuwen Lu, Xiaogan Liang, Ruiqi Wang, Rongrong Shen, Liang Yang, Jingwen Song, Shaofei Liu, Yuan Bai, Zhifu Guo, Ni Zhu","doi":"10.2174/011573403X376422250522094942","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to compare the quality of life and hemodynamic changes before and after transcatheter atrial septal shunt implantation.</p><p><strong>Methods: </strong>A systematic search was conducted in the Cochrane Library, PubMed, and Embase from inception to September 2023 for studies reporting on hemodynamics or quality of life in patients with chronic heart failure after atrial septal shunt implantation. A meta-analysis was performed, in which a total of 1026 participants from 13 articles were included.</p><p><strong>Results: </strong>Following the implantation, pulmonary capillary wedge pressure (PCWP) decreased by 2.60 mmHg. Right atrial pressure (RAP) increased by 1.30 mmHg and left ventricular ejection fraction (LVEF) increased by 2.13%. However, there were no significant differences in cardiac output and mean pulmonary artery pressure (mPAP) after operation. Minnesota Living with Heart Failure (MLWHF) Score decreased by -19.28, while the Kansas City Cardiomyopathy Questionnaire (KCCQ) score increased by 25.41. Moreover, 6-minute walking distance (6MWD) increased by 32.22 m. The results of subgroup analysis showed that for patients with heart failure with preserved ejection fraction (HFpEF) and heart failure with mildly reduced ejection fraction (HFmrEF), LVEF increased by 3.09% while CO increased by 1.01 L/min after operation. Meanwhile, PCWP significantly decreased by 2.67 mmHg and MLWHF scores decreased by 19.28. Additionally, 6MWD significantly increased by 27.5 m. However, there were no significant changes in RAP and mPAP after operation. For patients with heart failure with reduced ejection fraction (HFrEF), interatrial shunt device implantation did not achieve a significant increase in LVEF.</p><p><strong>Conclusion: </strong>These findings suggest that while atrial septal shunt implantation might not yield LVEF elevation among patients with HFrEF, it improves hemodynamic parameters, exercise endurance, and QoL among individuals with HFpEF/HFmrEF.</p>","PeriodicalId":10832,"journal":{"name":"Current Cardiology Reviews","volume":" ","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Improvement of Hemodynamics and Quality of Life Before and After Interatrial Shunt Devices Implantation for Chronic Heart Failure: A Systematic Review and Meta-analysis.\",\"authors\":\"Yugen Guan, Lei Yang, Yuwen Lu, Xiaogan Liang, Ruiqi Wang, Rongrong Shen, Liang Yang, Jingwen Song, Shaofei Liu, Yuan Bai, Zhifu Guo, Ni Zhu\",\"doi\":\"10.2174/011573403X376422250522094942\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>The objective of this study was to compare the quality of life and hemodynamic changes before and after transcatheter atrial septal shunt implantation.</p><p><strong>Methods: </strong>A systematic search was conducted in the Cochrane Library, PubMed, and Embase from inception to September 2023 for studies reporting on hemodynamics or quality of life in patients with chronic heart failure after atrial septal shunt implantation. A meta-analysis was performed, in which a total of 1026 participants from 13 articles were included.</p><p><strong>Results: </strong>Following the implantation, pulmonary capillary wedge pressure (PCWP) decreased by 2.60 mmHg. Right atrial pressure (RAP) increased by 1.30 mmHg and left ventricular ejection fraction (LVEF) increased by 2.13%. However, there were no significant differences in cardiac output and mean pulmonary artery pressure (mPAP) after operation. Minnesota Living with Heart Failure (MLWHF) Score decreased by -19.28, while the Kansas City Cardiomyopathy Questionnaire (KCCQ) score increased by 25.41. Moreover, 6-minute walking distance (6MWD) increased by 32.22 m. The results of subgroup analysis showed that for patients with heart failure with preserved ejection fraction (HFpEF) and heart failure with mildly reduced ejection fraction (HFmrEF), LVEF increased by 3.09% while CO increased by 1.01 L/min after operation. Meanwhile, PCWP significantly decreased by 2.67 mmHg and MLWHF scores decreased by 19.28. Additionally, 6MWD significantly increased by 27.5 m. However, there were no significant changes in RAP and mPAP after operation. For patients with heart failure with reduced ejection fraction (HFrEF), interatrial shunt device implantation did not achieve a significant increase in LVEF.</p><p><strong>Conclusion: </strong>These findings suggest that while atrial septal shunt implantation might not yield LVEF elevation among patients with HFrEF, it improves hemodynamic parameters, exercise endurance, and QoL among individuals with HFpEF/HFmrEF.</p>\",\"PeriodicalId\":10832,\"journal\":{\"name\":\"Current Cardiology Reviews\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2025-06-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Current Cardiology Reviews\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2174/011573403X376422250522094942\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Cardiology Reviews","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2174/011573403X376422250522094942","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Improvement of Hemodynamics and Quality of Life Before and After Interatrial Shunt Devices Implantation for Chronic Heart Failure: A Systematic Review and Meta-analysis.
Objective: The objective of this study was to compare the quality of life and hemodynamic changes before and after transcatheter atrial septal shunt implantation.
Methods: A systematic search was conducted in the Cochrane Library, PubMed, and Embase from inception to September 2023 for studies reporting on hemodynamics or quality of life in patients with chronic heart failure after atrial septal shunt implantation. A meta-analysis was performed, in which a total of 1026 participants from 13 articles were included.
Results: Following the implantation, pulmonary capillary wedge pressure (PCWP) decreased by 2.60 mmHg. Right atrial pressure (RAP) increased by 1.30 mmHg and left ventricular ejection fraction (LVEF) increased by 2.13%. However, there were no significant differences in cardiac output and mean pulmonary artery pressure (mPAP) after operation. Minnesota Living with Heart Failure (MLWHF) Score decreased by -19.28, while the Kansas City Cardiomyopathy Questionnaire (KCCQ) score increased by 25.41. Moreover, 6-minute walking distance (6MWD) increased by 32.22 m. The results of subgroup analysis showed that for patients with heart failure with preserved ejection fraction (HFpEF) and heart failure with mildly reduced ejection fraction (HFmrEF), LVEF increased by 3.09% while CO increased by 1.01 L/min after operation. Meanwhile, PCWP significantly decreased by 2.67 mmHg and MLWHF scores decreased by 19.28. Additionally, 6MWD significantly increased by 27.5 m. However, there were no significant changes in RAP and mPAP after operation. For patients with heart failure with reduced ejection fraction (HFrEF), interatrial shunt device implantation did not achieve a significant increase in LVEF.
Conclusion: These findings suggest that while atrial septal shunt implantation might not yield LVEF elevation among patients with HFrEF, it improves hemodynamic parameters, exercise endurance, and QoL among individuals with HFpEF/HFmrEF.
期刊介绍：
Current Cardiology Reviews publishes frontier reviews of high quality on all the latest advances on the practical and clinical approach to the diagnosis and treatment of cardiovascular disease. All relevant areas are covered by the journal including arrhythmia, congestive heart failure, cardiomyopathy, congenital heart disease, drugs, methodology, pacing, and preventive cardiology. The journal is essential reading for all researchers and clinicians in cardiology.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
