Evidence map›Paper›PMID 42364251›Full record

ArticleESC heart failure2026

Right ventricular to pulmonary artery coupling and clinical outcomes after interatrial shunting in heart failure: exploratory analysis of the PRELIEVE study.

Nijad Bakhshaliyev, Emiliano Fiori, Christina Paitazoglou, Martin Bergmann, Roman Pfister, Felix Mahfoud, Teoman Kılıç, Ramazan Özdemir, Stefan Anker, Jozef Bartunek

Registry-linked trialAbstract readMulticenter Study
In one paragraph

Article in ESC heart failure, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03030274 (Prospective, Non-randomized, Pilot Study to Assess Safety and Efficacy of a Novel Atrial Flow Regulator), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03030274 nacompletednot on this map

Prospective, Non-randomized, Pilot Study to Assess Safety and Efficacy of a Novel Atrial Flow Regulator (AFR) in Heart Failure Patients With Reduced Ejection Fraction or in Heart Failure Patients With Preserved Ejection Fraction

TypeinterventionalSponsorOcclutech International ABRan2017 to 2022Enrolled106ConditionsHeart Failure Low Output, Heart FailureArmsOcclutech AFR device
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Nijad BakhshaliyevDepartment of Cardiology, Ege Hospital, 38, AZ1078 Academician Hasan Aliyev St, Baku, Azerbaigian.
Emiliano FioriCardiovascular Center Aalst, AZORG-Clinic, Moorselbaan 164, 9300 Aalst, Belgium.
Christina PaitazoglouInterventional Cardiology, Cardiologicum Hamburg, Hamburg, Germany.
Martin BergmannInterventional Cardiology, Cardiologicum Hamburg, Hamburg, Germany.
Roman PfisterDepartment III of Internal Medicine, Heart Center, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.ORCID 0000-0002-4358-5008
Felix MahfoudClinic for Cardiology, University Heart Center, Universitätsspital CH, Petersgraben 4, 4031 Basel, Switzerland.
Teoman KılıçDepartment of Cardiology, Kocaeli University Medical Faculty, Kocaeli, Turkey.
Ramazan ÖzdemirDepartment of Cardiology, Bezmiâlem Vakıf University, Istanbul, Turkey.
Stefan AnkerDepartment of Cardiology (CVK) and Berlin Institute of Health Center for Regenerative Therapies (BCRT), German Centre for Cardiovascular Research (DZHK) Partner Site Berlin, Charité Universitätsmedizin Berlin, Berlin, Germany.
Jozef BartunekCardiovascular Center Aalst, AZORG-Clinic, Moorselbaan 164, 9300 Aalst, Belgium.

Funding

DigiCardiopaTh PhD programSapienza University of Rome
6 · The paper itself

Abstract

introductionHeterogeneous outcomes were reported in studies targeting left atrial (LA) pressure reduction by interatrial shunting in heart failure (HF). Right ventricular (RV) performance and pulmonary arterial (PA) afterload are essential in assuring the efficient blood flow shunting through the pulmonary circulation. We investigated whether baseline RV-PA coupling, expressed as the tricuspid annular plane systolic excursion (TAPSE) to pulmonary artery systolic pressure (PASP) ratio, is associated with outcomes after atrial flow regulator (AFR) implantation in the PRELIEVE study.

methodsIn this post hoc analysis of the multicentre, single-arm PRELIEVE study (NCT03030274), 106 patients with symptomatic HF (62 with reduced and 44 with preserved ejection fraction) underwent AFR implantation and were followed for 12 months. TAPSE/PASP was measured by echocardiography at baseline and 3 months. The primary composite endpoint was cardiovascular (CV) death or HF hospitalization (HFH).

resultsDuring follow-up, 19 patients (18%) experienced the composite endpoint. At baseline, these patients had higher NT-proBNP [1261 (567, 1790) vs. 317 (114, 1200) pg/mL; P = .009] and lower TAPSE/PASP [0.43 (0.33-0.53) vs 0.53 (0.43-0.76), P = .04]. In Kaplan-Meier analysis, lowest TAPSE/PASP ratio tended to show the worst outcome (P = .07). Using recurrent-event Poisson regression, lower baseline TAPSE/PASP was associated with a higher cumulative incidence of HFHs [incidence rate ratio 2.4 (95% CI 1.0-5.6) for lowest vs middle tertile, P = .039].

conclusionIn patients with HF undergoing interatrial shunting, impaired baseline RV-PA coupling assessed by a low TAPSE/PASP ratio was associated with higher rates of CV death or recurrent HF hospitalizations. The potential value of baseline RV-PA uncoupling in identifying responders to LA shunt therapies requires prospective evaluation in adequately powered prospective studies.

Indexed as

Heart AtriaHeart FailureHeart VentriclesPulmonary ArteryStroke VolumeVentricular Function, RightAgedEchocardiographyFemaleFollow-Up StudiesHumansMaleMiddle AgedDevice-based therapyHeart failureInteratrial shuntRV-PA coupling

Identifiers

PMID42364251
PMCPMC13395077

What Socratic holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.