Pulmonary-artery denervation, in addition to guideline-directed medical therapy, resulted in fewer events of clinical worsening than medical therapy alone in patients with pulmonary hypertension associated with left heart disease and heart failure (HF), based on findings from the PADN-HF-PH trial presented at ESC Congress 2026 and simultaneously published in NEJM.

The multicenter trial from China randomized 264 patients to either pulmonary-artery denervation plus medical therapy or to medical therapy alone. The primary outcome was clinical worsening, defined as a composite of death, heart or lung transplantation, hospitalization for HF, outpatient worsening of HF, or a decline in the 6-minute walk distance, over a median follow up 338 days.

According to Hang Zhang, MD, and Qiguang Wang, MD, et al., the Kaplan-Meier estimated two-year incidence of clinical worsening was nearly 26% in the pulmonary-artery denervation group compared with nearly 52% in the medical therapy group. No procedural complications were observed outside of two patients with access-site hematomas in the denervation group and one patient in the medical therapy group. There were no significant differences in the frequency of adverse events across both groups.

“Despite major advances in pharmacologic and device-based therapies, pulmonary hypertension remains one of the strongest predictors of hospitalization, right ventricular failure, and death in patients with left heart disease and heart failure,” said Zhang and colleagues. “… Additional long-term follow-up will be important to determine whether the observed mid-term improvements translate into sustained reductions in mortality and hospitalization for HF.”

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Clinical Topics: Arrhythmias and Clinical EP, Cardiovascular Care Team, Diabetes and Cardiometabolic Disease, Heart Failure and Cardiomyopathies, Prevention, Pulmonary Hypertension and Venous Thromboembolism, Vascular Medicine, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, Acute Heart Failure, Pulmonary Hypertension, Hypertension

Keywords: ESC Congress, ESC26, Hypertension, Pulmonary, Heart Failure, Catheter Ablation, Pulmonary Artery