Evidence map›Paper›PMID 37312287›Full record

SynthesisESC heart failure2023

Predicted impact of atrial flow regulator on survival in heart failure with reduced and preserved ejection fraction.

Lucas Lauder, Martin W Bergmann, Christina Paitazoglou, Ramazan Özdemir, Christos Iliadis, Jozef Bartunek, Alexander Lauten, Thomas Keller, Stephan Weber, Horst Sievert and 2 more

Registry-linked trialOpen access · goldAbstract readMeta-Analysis
In one paragraph

Synthesis in ESC heart failure, 2023. 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. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.1field-weighted citation impact, top 21% of its field
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

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
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

12 authors at 10 institutions in 3 countries.

Lucas LauderKlinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes and Saarland University, Homburg, Germany.ORCID 0000-0003-1434-9556
Martin W BergmannDepartment of Interventional Cardiology, Cardiologicum Hamburg, Hamburg, Germany.
Christina PaitazoglouUniversity Heart Center Lübeck, Medical Clinic II, Cardiology, Angiology, Intensive Care Medicine, UKSH University Hospital Schleswig Holstein, Lübeck, Germany.
Ramazan ÖzdemirDepartment of Cardiology, Bezmiâlem Vakıf University, Istanbul, Turkey.
Christos IliadisDepartment of Cardiology, Pulmonology, Angiology and Intensive Care Medicine, Heart Center University Clinic Köln, Köln, Germany.
Jozef BartunekCardiovascular Center, Onze-Lieve-Vrouw Hospital, Aalst, Belgium.
Alexander LautenDepartment of General and Interventional Cardiology, Helios Klinikum Erfurt, Erfurt, Germany.
Thomas KellerACOMED Statistik, Leipzig, Germany.
Stephan WeberACOMED Statistik, Leipzig, Germany.
Horst SievertCardiovascular Center Frankfurt, Frankfurt, Germany.
Stefan D 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.
Felix MahfoudKlinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes and Saarland University, Homburg, Germany.ORCID 0000-0002-4425-549X
Statistisches Bundesamt · DEUniversitätsklinikum des Saarlandes · DEBezmiâlem Vakıf Üniversitesi · TRCardiovascular Center Frankfurt · DEDermatologikum Hamburg · DEGerman Centre for Cardiovascular Research · DEHelios Klinikum Erfurt · DELVR-Klinik Köln · DEOnze Lieve Vrouwziekenhuis Hospital · BEUniversity Hospital Schleswig-Holstein · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsWe aim to assess the theoretical impact of the atrial flow regulator (AFR) on survival in heart failure. METHODS AND

resultsThe prospective, multicentre, open-label, non-randomised PRELIEVE study (NCT03030274) assessed the safety and efficacy of the Occlutech AFR device in patients with symptomatic heart failure with reduced ejection fraction (HFrEF) (left ventricular ejection fraction (LVEF) ≥ 15% and <40%) or heart failure with preserved ejection fraction (HFpEF) (LVEF ≥40% and <70%) and elevated PCWP (≥15 mmHg at rest or ≥25 mmHg during exercise). In this analysis, after the first 60 patients completed 12 months of follow-up, the theoretical impact of AFR implantation on survival was assessed by comparing the observed mortality rate with the median predicted probability for one-year mortality. Each subject's risk of mortality was predicted from individual baseline data using the Meta-Analysis Global Group in Chronic HF (MAGGIC) prognostic model. A total of 87 patients (46% female, median age 69 years [IQR 62-74]) had undergone successful device implantation for the treatment of HFrEF (53%) and HFpEF (47%). Sixty patients had a complete 12 month follow-up. The median follow-up was 351 days (interquartile range [IQR] 202-370). Six (7%) patients died during follow-up (8.6 deaths per 100 patient-years; 95% confidence interval [CI] 2.7 to 15.5), all of which had HFrEF. The median predicted mortality rate for the overall study population was 12.2 deaths per 100 patient-years (95% CI 10.2 to 14.7). While the observed mortality rate (0 deaths per 100 patient-years) was significantly lower than the median predicted mortality rate (9.3 deaths per 100 patient-years; 95% CI 8.4 to 11.1) in patients with HFpEF (-9.3 deaths per 100 patient-years; 95% CI -11.1 to -8.4), there was no difference in patients with HFrEF (-3.6 deaths per 100 patient-years; 95% CI -9.5 to 3.0). Four deaths were HF-related deaths (5.7 HF-related deaths per 100 patient-years; 95% CI 1.4 to 11.9; 10.8 HF-related deaths per 100 patient-years; 95% CI 2.5 to 23.1 in the HFrEF subgroup).

conclusionsIn patients with HFpEF, the mortality rate following AFR implantation was lower than the predicted mortality rate. Dedicated randomised, controlled trials are needed - and currently ongoing - to investigate whether the AFR improves mortality.

Indexed as

Atrial FibrillationHeart FailureVentricular Dysfunction, LeftAgedFemaleHumansMaleProspective StudiesStroke VolumeVentricular Function, LeftChronic heart failureDevice-based therapyExertional dyspnoeaPulmonary congestion

Identifiers

PMID37312287
PMCPMC10375067
OpenAlexW4380442253

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

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 OpenQuestion graph.