LAUSR

Interatrial shunt (IAS) devices are emerging as a novel treatment option for patients with heart failure (HF) and mildly reduced or preserved ejection fraction (HFpEF).1–3 Latent pulmonary vascular disease might affect the benefits of IAS devices.1 Schuster et al.4 hypothesized that non-invasive characterization of cardiac and pulmonary physiology by cardiac magnetic resonance (CMR) during exercise may help in patient selection for IAS. Overall, 75 patients with HFpEF who underwent rest and exercise stress right heart catheterization, echocardiography and CMR were included. Latent pulmonary vascular disease, defined as pulmonary vascular resistance during exercise stress ≥1.74 Wood units, was associated with impaired right ventricular (RV) functional reserve and diastolic filling with a consequent reduction in left ventricular cardiac index.