Pulmonary artery denervation (PADN) plus standard medical therapy led to a significant improvement in the 6-minute walk distance (6MWD) and pulmonary vascular resistance (PVR), based on results from the PADN-5 study presented Sept. 23 at TCT 2018 and published in JACC: Interventions.

Researchers randomly assigned 98 patients with combined pre- and post-capillary pulmonary hypertension (CpcPH) to PADN or sildenafil plus sham PADN. Standard medical therapy for heart failure was administered to all patients in both groups. The primary endpoint was the increase in 6MWD at six-months follow-up. The primary safety endpoint was occurrence of pulmonary embolism. The secondary endpoint was change in PVR. Clinical worsening was assessed in a post-hoc analysis.

Results showed the mean increases in 6MWD were 83 m in the PADN group and 15 m in the sildenafil group. Additionally, PADN treatment was associated with significantly lower PVR compared with the sildenafil group. The findings also associated PADN plus standard medical therapy with a significantly lower rate of clinical worsening. (16.7 percent vs. 40 percent; p = 0.014). Hang Zhang, MD, et al., noted there were seven all-cause deaths and two cases of pulmonary embolism by the end of the study.

"PADN is associated with significant improvements in hemodynamic and clinical outcomes in patients with CpcPH," researchers said. However, they noted given the small sample size that "further studies are warranted to define its precise role in the treatment of this patient population."

Keywords: TCT18, Transcatheter Cardiovascular Therapeutics, Angiography, Percutaneous Coronary Intervention, Pulmonary Artery, Hypertension, Hypertension, Pulmonary, Denervation

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