Device-based solutions to improve cardiac physiology and hemodynamics in heart failure with preserved ejection fraction
journal contributionposted on 19.08.2021, 16:15 by Luca Rosalia, Caglar Ozturk, Saeed Shoar, Yiling Fan, Grainne Malone, Faisal H Cheema, Claire ConwayClaire Conway, Robert ByrneRobert Byrne, Garry DuffyGarry Duffy, Andrew MaloneAndrew Malone, Ellen T Roche, Aamir HameedAamir Hameed
Characterized by a rapidly increasing prevalence, elevated mortality and rehospitalization rates, and inadequacy of pharmaceutical therapies, heart failure with preserved ejection fraction (HFpEF) has motivated the widespread development of device-based solutions. HFpEF is a multifactorial disease of various etiologies and phenotypes, distinguished by diminished ventricular compliance, diastolic dysfunction, and symptoms of heart failure despite a normal ejection performance; these symptoms include pulmonary hypertension, limited cardiac reserve, autonomic imbalance, and exercise intolerance. Several types of atrial shunts, left ventricular expanders, stimulation-based therapies, and mechanical circulatory support devices are currently under development aiming to target one or more of these symptoms by addressing the associated mechanical or hemodynamic hallmarks. Although the majority of these solutions have shown promising results in clinical or preclinical studies, no device-based therapy has yet been approved for the treatment of patients with HFpEF. The purpose of this review is to discuss the rationale behind each of these devices and the findings from the initial testing phases, as well as the limitations and challenges associated with their clinical translation.
PReduction - A novel device for Heart Failure with preserved Ejection Fraction (HFpEF) | Funder: Enterprise Ireland | Grant ID: CF-2019-1136-P
European Regional Development Fund under Ireland’s European Structural and Investment Funds Programme 2014-2020.
CommentsThe original article is available at https://www.sciencedirect.com
Published CitationRosalia L. et at. Device-based solutions to improve cardiac physiology and hemodynamics in heart failure with preserved ejection fraction. JACC: Basic to Translational Science. 2021.
Publication Date4 August 2021
- Anatomy and Regenerative Medicine
- School of Pharmacy and Biomolecular Sciences
- Tissue Engineering Research Group (TERG)
- Surgical Science and Practice
- Biomaterials and Regenerative Medicine
- Accepted Version (Postprint)
atrial shunt deviceselectrostimulationheart failure devicesheart failure with preserved ejection fractionHFpEFleft ventricular expandersmechanical circulatory supportneuromodulationelevated mortalityrehospitalization ratesexercise intolerancemultifactorial diseaseventricular compliancediastolic dysfunctionHemodynamicscardiac physiology