Title | Treatment effects of pulmonary artery denervation for pulmonary arterial hypertension stratified by REVEAL risk score: Results from PADN-CFDA trial |
Authors | Zhang, Juan Kan, Jing Wei, Yongyue Zhang, Caojin Yang, Zhenwen Gu, Heping Fan, Fenling Gu, Hong Wang, Qiguang Xie, Dujiang Zhang, Gangcheng Guo, Xiaomei Yin, Yuehui Jin, Bowen Zhou, Hongmei Yang, Ziyang Wang, Zhouming Xin, Yu Zhang, Chen Meng, Lili Wang, Xiaoyu Zhao, Chunxia Zhang, Hang Yan, Xiaoyan Chen, Feng Yao, Cheng Benza, Raymond L. Stone, Gregg W. Chen, Shao-Liang |
Affiliation | Nanjing Med Univ, Nanjing Hosp 1, Div Cardiol, Nanjing, Jiangsu, Peoples R China Nanjing Med Univ, Sch Publ Hlth, Nanjing, Jiangsu, Peoples R China Guangdong Prov Peoples Hosp, Div Cardiol, Guangzhou, Guangdong, Peoples R China Tianjin Med Univ, Gen Hosp, Div Pulm Vasc Dis, Tianjin, Peoples R China Zhengzhou Univ, Hosp 1, Div Cardiol, Zhengzhou, Henan, Peoples R China Xi An Jiao Tong Univ, Affiliated Hosp 1, Div Pulm Vasc Dis, Xian, Shanxi, Peoples R China Capital Med Univ, Beijing Anzhen Hosp, Div Congenital Heart Dis, Beijing, Peoples R China Gen Hosp Northen Theater Command, Div Pulm Vasc Dis, Shenyang, Liaoning, Peoples R China Wuhan Univ, Zhongnan Hosp, Div Pulm Vasc Dis, Wuhan, Hubei, Peoples R China Huazhong Univ Sci & Technol, Tongji Hosp, Div Cardiol, Wuhan, Hubei, Peoples R China Chongqing Med Univ, Hosp 2, Div Cardiol, Chongqing, Peoples R China Wuhan Asia Heart Hosp, Div Pulm Vasc Dis, Wuhan, Hubei, Peoples R China Peking Univ, Clin Res Inst, Beijing, Peoples R China Ohio State Univ, Div Cardiovasc Med, Cleveland, OH USA Icahn Sch Med Mt Sinai, Zena & Michael A Wiener Cardiovasc Inst, New York, NY USA Nanjing Med Univ, Nanjing First Hosp, Div Cardiol, 68 Changle Rd, Nanjing 210006, Peoples R China |
Keywords | CALCULATOR |
Issue Date | Aug-2023 |
Publisher | JOURNAL OF HEART AND LUNG TRANSPLANTATION |
Abstract | BACKGROUND: The differential treatment effect of pulmonary artery denervation (PADN) in pulmonary arterial hypertension (PAH) patients with different risk burdens remains unclear. This study aimed to determine the effectiveness of PADN in low vs intermediate-high-risk PAH patients. METHODS: In total, 128 patients with treatment naive PAH included in the PADN-CFDA trial were categorized into low-risk and intermediate-high-risk patients. The primary endpoint was the between group difference in the change in 6-min walk distance (6 MWD) from baseline to 6 months. RESULTS: In the intermediate-high-risk group, those treated with PADN and PDE-5i had a greater improvement in 6 MWD from baseline to 6 months as compared to those treated with sham plus PDE5i. From baseline to 6 months, pulmonary vascular resistance (PVR) was reduced by -6.1 & PLUSMN; 0.6 and -2.0 & PLUSMN; 0.7 Wood units following PADN plus PDE-5i and sham plus PDE-5i, respectively, along with the significant reduction of NT-proBNP in the intermediate-high-risk group. However, there were no significant differences in 6 MWD, PVR, and NT-proBNP between the PADN plus PDE-5i and sham plus PDE-5i groups among low-risk patients. Moreover, the right ventricular function was equally improved by PADN treatment across the low-, intermediate-, and high-risk groups. Clinical worsening was less with PADN plus PDE-5i treatment during the 6-month follow-up. CONCLUSIONS: In patients with pulmonary arterial hypertension, pulmonary artery denervation plus PDE-5i improved exercise capacity, NT-proBNP, hemodynamic, and clinical outcomes during the 6-month follow-up among intermediate-high risk patients. J Heart Lung Transplant 2023;42:1140-1151 & COPY; 2023 International Society for Heart and Lung Transplantation. All rights reserved. |
URI | http://hdl.handle.net/20.500.11897/690527 |
ISSN | 1053-2498 |
DOI | 10.1016/j.healun.2023.03.015 |
Indexed | SCI(E) |
Appears in Collections: | 医学部待认领 |