Treatment with pulmonary artery denervation (PADN) plus a phosphodiesterase-5 inhibitor (PDE-5i) was safe in patients with stable pulmonary arterial hypertension (PAH), based on findings from the PADN-CFDA study presented Sept. 18 during TCT 2022 and simultaneously published in JACC: Cardiovascular Interventions. Researchers also noted improved exercise capacity at six months compared with patients receiving PDE-5i treatment alone.

Researchers in China randomized 128 patients with WHO Group I PAH who were not taking PAH-specific drugs for at least 30 days to either PADN plus a PDE-5i or a sham procedure plus a PDE-5i. The primary endpoint was the between-group difference in the change in six-minute walk distance (6MWD) from baseline to six months.

Overall findings found those patients treated with PADN had a greater improvement in 6MWD compared with those in the sham group. PADN also resulted in greater reductions in pulmonary vascular resistance between baseline and six months compared with sham, as well as improvements in right ventricular function, reduced tricuspid regurgitation and decreased NT-proBNP. Hang Zhang, MD, Shao-Liang Chen, MD, FACC, et al., also noted that "clinical worsening during six-month follow-up was reduced and a satisfactory clinical response at six months was more frequently achieved by PADN treatment."

While the findings show promise, Zhang, Chen and colleagues suggest that "results should be replicated in larger studies (especially in patients with a suboptimal response to combination pharmacotherapy) before widespread application of this novel approach."

Clinical Topics: Heart Failure and Cardiomyopathies, Pulmonary Hypertension and Venous Thromboembolism, Pulmonary Hypertension

Keywords: Transcatheter Cardiovascular Therapeutics, TCT22, Pulmonary Artery, Pulmonary Arterial Hypertension, Sympathectomy, Renal Artery

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