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Heart Failure With Reduced Ejection Fraction (HFrEF)Phase 2/3PAST-HFrEFNCT07820410

Atrial Shunt for the Treatment of Heart Failure With Reduced Ejection Fraction

A Phase 2/3 study testing D-shant Atrial Shunt and Guideline-Directed Medical Therapy (GDMT) for heart failure with reduced ejection fraction in people with Heart Failure With Reduced Ejection Fraction (HFrEF), run by Beijing Anzhen Hospital at 1 site in China.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

To evaluate the safety and effectiveness of the Atrial Shunt for the treatment of heart failure with reduced ejection fraction (HFrEF) Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
D-shant Atrial Shunt and Guideline-Directed Medical Therapy (GDMT) for heart failure with reduced ejection fraction
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
208 participants
Where
1 siteChina
Study dates
25 Nov 2024to 31 Dec 2027
Phase
Phase 2/3
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • 1. Age ≥ 18 years 2. Diagnosed with HFrEF and receiving Guideline-Directed Medical Therapy (GDMT) for at least 1 month 3. Echocardiographic LVEF between 20% and 40% (20 ≤ LVEF ≤ 40%) 4. Presence of HF-related symptoms and signs, NYHA Class III 5. At least one HF-related hospitalization in the past year or NT-proBNP ≥ 600 pg/mL (sinus rhythm) / ≥ 1000 pg/mL (atrial fibrillation) 6. Invasive hemodynamics: mLAP or mPCWP ≥ 15 mmHg, or left-to-right mean pressure gradient ≥ 5 mmHg 7. Fully understand the study design and follow-up schedule, agrees to participate, and voluntarily signs the Informed Consent Form

Who cannot join

  • 1. End-stage heart failure on the heart transplant waiting list (including meeting LVAD indications) 2. Three consecutive non-invasive systolic blood pressure readings < 90 mmHg 3. Primary structural valvular disease currently indicating surgery or interventional therapy, or severe coronary artery disease requiring revascularization 4. ECG QRS duration ≥ 130 ms with high risk of sudden cardiac death without therapeutic intervention (including meeting CRT/CRT-D indications) 5. Significant right ventricular (RV) dysfunction or severe pulmonary hypertension. Defined by clinical evidence of hepatic congestion, moderate-to-severe edema, or abdominal distension accompanied by poor appetite; significant right atrial or RV enlargement/dysfunction; moderate-to-severe tricuspid regurgitation; mean right atrial pressure > 10 mmHg; systolic pulmonary artery pressure > 60 mmHg; or pulmonary vascular resistance > 3 Wood Units 6. Myocardial infarction or cardiac intervention within the past 1 month 7. Stroke within the past 1 month (excluding lacunar infarction) 8. Decompensated liver cirrhosis (Child-Pugh Class B or worse), or severe chronic pulmonary disease requiring oxygen therapy 9. Anatomical abnormalities precluding procedure completion or making the patient unsuitable for procedure 10. Atrial thrombosis 11. Contraindication to antithrombotic therapy 12. Life expectancy < 1 year 13. Uncontrolled active infection 14. Pregnant, lactating, or women of childbearing potential planning pregnancy in the near future 15. Currently participating in another drug or medical device clinical trial 16. Investigator deems the patient unsuitable for this trial

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Sanshuai Chang, M.D. contact

+8618501369869

18501369869@163.com

Guangyuan Song, M.D. contact

+8613801120805

songgy_anzhen@vip.163.com

China1 site, 1 recruiting
  • Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital

    Beijing, Beijing Municipality, 100029

    Sanshuai Chang, M.D., +8618501369869, 18501369869@163.com

    Recruiting

Other trials in China

About this study

Official title: A Prospective, Randomized, Open-Label, Parallel-Controlled, Superiority, Multicenter Clinical Study of Atrial Shunt for the Treatment of Heart Failure With Reduced Ejection Fraction

To evaluate the safety and effectiveness of the Atrial Shunt for the treatment of heart failure with reduced ejection fraction (HFrEF)

Read the detailed description

This is a prospective, randomized, open-label, parallel-controlled, superiority, multicenter clinical study. A total of 208 subjects will be randomized 1:1 after meeting all inclusion/exclusion criteria.

Treatment Group: atrial shunt implantation post-right heart catheterization. Control Group: Right heart catheterization only. Both groups will receive standardized Guideline-Directed Medical Therapy (GDMT) post-procedure. Assessments and follow-ups will be conducted at pre-procedure baseline, day of procedure, 1 week, 1 month, 3 months, 6 months, and 12 months post-procedure.

A Clinical Event Committee (CEC), composed of third-party cardiovascular experts, will independently review and adjudicate primary endpoints in a blinded manner (surgical information concealed).

Being tested
D-shant Atrial Shunt, Guideline-Directed Medical Therapy (GDMT) for heart failure with reduced ejection fraction
Keywords
Heart Failure with Reduced Ejection Fraction, Atrial shunt

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • D-shant Atrial ShuntDevice

    The D-Shant atrial shunt device is a novel device therapy for heart failure, classified as a non-active implantable cardiovascular device. It is manufactured using a braided Nitinol technique, thermally set via assembly molds to form a waist with a fixed-orifice support and a hollow double-disc structure. Braided wires reinforce waist support and maintain a circular orifice shape. Once implanted, it forms a stable interatrial shunt. The device is delivered via the femoral vein to the interatrial septum, where the shunt orifice facilitates blood flow diversion and pressure decompression. Various models with different waist and disc diameters are available to accommodate varying degrees and etiologies of heart failure.

  • Guideline-Directed Medical Therapy (GDMT) for heart failure with reduced ejection fractionDrug

    Guideline-Directed Medical Therapy (GDMT) for heart failure with reduced ejection fraction

Study groups in NCT07820410
Study groupRoleWhat they receive
Device group (Interventional group)ExperimentalPatients will receive atrial shunt for heart failure treatment plus maximally tolerated guideline-directed medical therapy for cardiovascular disease
Receives: Device: D-shant Atrial Shunt; Drug: Guideline-Directed Medical Therapy (GDMT) for heart failure with reduced ejection fraction
no Device group (Control Group)Active comparatorPatients will receive maximally tolerated guideline-directed medical therapy for heart failure only
Receives: Drug: Guideline-Directed Medical Therapy (GDMT) for heart failure with reduced ejection fraction

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. A composite event of all-cause mortality, heart transplantation or left ventricular assist device implantation due to heart failure, heart failure-related rehospitalization post-procedure and Unplanned outpatient worsening heart failure within 12 months

    A composite event of all-cause mortality, heart transplantation or left ventricular assist device implantation due to heart failure, heart failure-related rehospitalization post-procedure and Unplanned outpatient worsening heart failure within 12 months. Hospitalization for heart failure requires an admission to an in-patient unit or an emergency room stay for ≥24 hours (or <24 hours if subject dies in the emergency room). - Outpatient worsening heart failure requires an unplanned visit to a doctor's office, urgent care center or emergency room visit with stay <24 hours. - Worsening heart failure must be present for both conditions, the definition of which requires all three of the following to be present: 1. Deterioration of HF symptoms: at least 1 of the following symptoms 2. Deterioration of HF signs: 2 physical examination findings or 1 physical examination + 1 laboratory or invasive finding 3. Urgent escalation of therapy

    Measured: From enrollment to the end of treatment at 12 months

Secondary outcomes (24)
  1. 6-minute walk distance (6MWD) (0-1000m, higher scores indicate a better outcome)

    Change in exercise capacity post-procedure: 6-Minute Walk Test

    Measured: From enrollment to the end of treatment at 12 months

  2. New York Heart Association (NYHA) Functional Classification (I-IV, higher scores indicate a worse outcome)

    Change in New York Heart Association (NYHA) Functional Classification

    Measured: From enrollment to the end of treatment at 12 months

  3. Change in NT-proBNP levels

    Change in NT-proBNP levels

    Measured: From enrollment to the end of treatment at 12 months

  4. Left atrial diameter

    Echocardiographic Left atrial diameter

    Measured: From enrollment to the end of treatment at 12 months

  5. Device Success Rates (Treatment Group)

    Device Success is defined as successful implantation of the shunt with normal morphology and position, visible left-to-right shunt on echocardiography, and an immediate decrease in mean Left Atrial Pressure (mLAP) or mean Pulmonary Capillary Wedge Pressure (mPCWP) compared to pre-implantation.

    Measured: From enrollment to the end of treatment at 12 months

  6. Changes in 12-lead Electrocardiogram (ECG)

    Presence of arrhythmias

    Measured: From enrollment to the end of treatment at 12 months

  7. Shunt Orifice Patency/Occlusion Status (Treatment Group)

    Shunt Orifice Patency/Occlusion Status (Treatment Group)

    Measured: From enrollment to the end of treatment at 12 months

  8. All-cause mortality rate

    All-cause mortality rate

    Measured: From enrollment to the end of treatment at 12 months

  9. Number of HF-related rehospitalizations post-procedure

    Number of HF-related rehospitalizations post-procedure

    Measured: From enrollment to the end of treatment at 12 months

  10. Kansas City Cardiomyopathy Questionnaire (KCCQ) score (0-100, higher scores indicate a better outcome)

    Change in Kansas City Cardiomyopathy Questionnaire (KCCQ) score

    Measured: From enrollment to the end of treatment at 12 months

  11. Right atrial diameter

    Echocardiographic right atrial diameter

    Measured: From enrollment to the end of treatment at 12 months

  12. Left ventricular diameter

    Echocardiographic left ventricular diameter

    Measured: From enrollment to the end of treatment at 12 months

  13. Right ventricular diameter

    Echocardiographic reft atrial diameter

    Measured: From enrollment to the end of treatment at 12 months

  14. Left Ventricular Ejection Fraction

    Echocardiographic Left Ventricular Ejection Fraction

    Measured: From enrollment to the end of treatment at 12 months

  15. Tricuspid Annular Plane Systolic Excursion

    Echocardiographic Tricuspid Annular Plane Systolic Excursion

    Measured: From enrollment to the end of treatment at 12 months

  16. Right Ventricular Fractional Area

    Echocardiographic Right Ventricular Fractional Area

    Measured: From enrollment to the end of treatment at 12 months

  17. Aortic regurgitation

    Echocardiographic aortic regurgitation

    Measured: From enrollment to the end of treatment at 12 months

  18. Mitral regurgitation

    Echocardiographic mitral regurgitation

    Measured: From enrollment to the end of treatment at 12 months

  19. Tricuspid regurgitation

    Echocardiographic tricuspid regurgitation

    Measured: From enrollment to the end of treatment at 12 months

  20. Shunt orifice diameter

    Echocardiographic Shunt orifice diameter

    Measured: From enrollment to the end of treatment at 12 months

  21. Shunt flow velocity

    Echocardiographic shunt flow velocity

    Measured: From enrollment to the end of treatment at 12 months

  22. Trans-shunt pressure gradient

    Echocardiographic trans-shunt pressure gradient

    Measured: From enrollment to the end of treatment at 12 months

  23. Shunt flow direction

    Echocardiographic shunt flow direction

    Measured: From enrollment to the end of treatment at 12 months

  24. Procedural Success Rates (Treatment Group)

    Procedural Success is defined as achieving Device Success with the patient surviving to hospital discharge.

    Measured: From enrollment to the end of treatment at 12 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted15 Sep 2026
  2. Study start25 Nov 2024
  3. Primary completion31 Dec 2027 (estimated)
  4. Study completion31 Dec 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2/3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
208 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07820410
Sponsor's protocol ID
BeijingAnzhen20260716
Acronym
PAST-HFrEF
Status last verified
Sep 2026
First submitted
16 Jul 2026
Last updated
15 Sep 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Questions about this trial

What is this clinical trial studying?

A Phase 2/3 study testing D-shant Atrial Shunt and Guideline-Directed Medical Therapy (GDMT) for heart failure with reduced ejection fraction in people with Heart Failure With Reduced Ejection Fraction (HFrEF), run by Beijing Anzhen Hospital at 1 site in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 15 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Sanshuai Chang, M.D. (+8618501369869, 18501369869@163.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

A composite event of all-cause mortality, heart transplantation or left ventricular assist device implantation due to heart failure, heart failure-related rehospitalization post-procedure and Unplanned outpatient worsening heart failure within 12 months (time frame: From enrollment to the end of treatment at 12 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Sep 2026.

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