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The Framework of Circulatory Equilibrium Can Predict the Quantitative Impact of Interatrial Shunt for Left Heart Failure on Hemodynamics

      Background: Interatrial shunting (IAS) have been reported to lower left atrial pressure (LAP) in heart failure (HF). However, its quantitative impact on hemodynamics has not been explored. We predicted the impact of IAS on hemodynamics by the framework of circulatory equilibrium. Method: In 4 mongrel dogs, we connected the left and right atrium with centrifugal pump to create IAS and measured hemodynamics. We ligated left coronary arteries to create LHF. We predicted hemodynamic variables from the framework of circulatory equilibrium (Fig. 1) and compared with those measured. Result: The predicted systemic flow (r2 = 0.66, SEE 16.3 ml/min/kg) and LAP (r2 = 0.90, SEE 0.56 mmHg) matched well with those measured. Conclusion: The framework of circulatory equilibrium can quantitatively predict hemodynamic impacts of IAS, and thereby contributes to hemodynamic management of IAS for HF.
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