Treatment effects of pulmonary artery denervation for pulmonary arterial hypertension stratified by REVEAL risk score: Results from PADN-CFDA trial

作者全名："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"

作者地址："[Zhang, Juan; Kan, Jing; Zhang, Hang; Chen, Shao-Liang] Nanjing Med Univ, Nanjing Hosp 1, Div Cardiol, Nanjing, Jiangsu, Peoples R China; [Wei, Yongyue; Chen, Feng] Nanjing Med Univ, Sch Publ Hlth, Nanjing, Jiangsu, Peoples R China; [Zhang, Caojin; Yang, Ziyang] Guangdong Prov Peoples Hosp, Div Cardiol, Guangzhou, Guangdong, Peoples R China; [Yang, Zhenwen; Wang, Zhouming] Tianjin Med Univ, Gen Hosp, Div Pulm Vasc Dis, Tianjin, Peoples R China; [Gu, Heping] Zhengzhou Univ, Hosp 1, Div Cardiol, Zhengzhou, Henan, Peoples R China; [Fan, Fenling] Xi An Jiao Tong Univ, Affiliated Hosp 1, Div Pulm Vasc Dis, Xian, Shanxi, Peoples R China; [Gu, Hong; Zhang, Chen] Capital Med Univ, Beijing Anzhen Hosp, Div Congenital Heart Dis, Beijing, Peoples R China; [Wang, Qiguang; Meng, Lili] Gen Hosp Northen Theater Command, Div Pulm Vasc Dis, Shenyang, Liaoning, Peoples R China; [Zhang, Gangcheng] Wuhan Univ, Zhongnan Hosp, Div Pulm Vasc Dis, Wuhan, Hubei, Peoples R China; [Guo, Xiaomei; Zhao, Chunxia] Huazhong Univ Sci & Technol, Tongji Hosp, Div Cardiol, Wuhan, Hubei, Peoples R China; [Yin, Yuehui] Chongqing Med Univ, Hosp 2, Div Cardiol, Chongqing, Peoples R China; [Jin, Bowen; Zhou, Hongmei] Wuhan Asia Heart Hosp, Div Pulm Vasc Dis, Wuhan, Hubei, Peoples R China; [Yan, Xiaoyan; Yao, Cheng] Peking Univ, Clin Res Inst, Beijing, Peoples R China; [Benza, Raymond L.] Ohio State Univ, Div Cardiovasc Med, Cleveland, OH USA; [Stone, Gregg W.] Icahn Sch Med Mt Sinai, Zena & Michael A Wiener Cardiovasc Inst, New York, NY USA; [Chen, Shao-Liang] Nanjing Med Univ, Nanjing First Hosp, Div Cardiol, 68 Changle Rd, Nanjing 210006, Peoples R China"

通信作者："Chen, SL (通讯作者)，Nanjing Med Univ, Nanjing First Hosp, Div Cardiol, 68 Changle Rd, Nanjing 210006, Peoples R China."

来源：JOURNAL OF HEART AND LUNG TRANSPLANTATION

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001052521200001

JCR分区：Q1

影响因子：6.4

年份：2023

卷号：42

期号：8

开始页：1140

结束页：1151

文献类型：Article

关键词：risk stratification; pulmonary arterial hypertension; pulmonary artery denervation; pulmonary arterial pressure; 6-min walk distance

摘要："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."

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