CBS 2019
CBSMD教育中心
中 文

科学研究

Abstract

Recommended Article

Diagnosis and management of acute deep vein thrombosis: a joint consensus document from the European Society of Cardiology working groups of aorta and peripheral vascular diseases and pulmonary circulation and right ventricular function The Comparison of Clinical Outcomes After Drug-Eluting Balloon and Drug-Eluting Stent Use for Left Main Bifurcation In-Stent Restenosis Patient and Hospital Characteristics of Mitral Valve Surgery in the United States Gut microbiota induces high platelet response in patients with ST segment elevation myocardial infarction after ticagrelor treatment Bench testing and coronary artery bifurcations: a consensus document from the European Bifurcation Club The Relation Between Optical Coherence Tomography-Detected Layered Pattern and Acute Side Branch Occlusion After Provisional Stenting of Coronary Bifurcation Lesions Nicotine promotes vascular calcification via intracellular Ca21-mediated, Nox5-induced oxidative stress, and extracellular vesicle release in vascular smooth muscle cells Intravascular optical coherence tomography
|<<... 178 179 180 181 182 183 184 ...>>|

Clinical Trial2019 Feb 11;12(3):274-284.

JOURNAL：JACC Cardiovasc Interv. Article Link

Pulmonary Artery Denervation Significantly Increases 6-minute Walk Distance for Patients with Combined Pre- and Post-capillary Pulmonary Hypertension Associated with the Left Heart Failure: PADN-5 Study

H Zhang, YL Han and SL Chen et al. Keywords: pulmonary hypertension; pulmonary artery denervation; 6-minute walk distance; heart failure

ABSTRACT

BACKGROUND - Pulmonary artery denervation (PADN) has been shown to improve hemodynamics of pulmonary arterial hypertension (PAH) in a series of patients. Additionally, benefits of targeted medical therapy for patients with combined pre- and post-capillary pulmonary hypertension (CpcPH) secondary to left sided heart failure are unknown.


OBJECTIVES - We sought to assess the benefits of PADN among CpcPH patients in a prospective, randomized sham-controlled trial.


METHODS - Ninety-eight CpcPH patients, defined as mean pulmonary arterial pressure ≥25 mmHg, pulmonary capillary wedge pressure >15 mmHg, and pulmonary vascular resistance (PVR] > 3.0 Woods Units, were randomly assigned 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 the 6-minute walk distance (6MWD) at the 6-month follow-up. The secondary endpoint was change in PVR. Clinical worsening was assessed in a post-hoc analysis. The main safety endpoint was occurrence of pulmonary embolism.


RESULTS - At 6-months, the mean increases in the 6MWD were 83 m in the PADN group and 15 m in the sildenafil group (least square mean difference 66 m, 95% confidence interval 38.2 to 98.8; p < 0.001). PADN treatment was associated with a significantly lower PVR than in the sildenafil group (4.2 ± 1.5 vs. 6.1 ± 2.9 Wood Units, p = 0.001). Clinical worsening was less frequent in the PADN group compared to the sildenafil group (16.7% vs. 40%, p = 0.014). At the end of the study, there were 7 all-cause deaths and 2 cases of pulmonary embolism.


CONCLUSIONS - PADN is associated with significant improvements in hemodynamic and clinical outcomes in patients with CpcPH. Further studies are warranted to define its precise role in the treatment of this patient population.

>CBS CBS 2019

> CBS 2019 REGISTRATION

> CBS 2019 PROGRAM

> CBS 2019 CALL FOR SCIENCE

> CBS 2019 SPOTLIGHTS

 CBSMD

> CBSMD WEBSITE REGISTRATION

> EDUCATION CENTER

> RECOMMANDED PAPER

> TOP 10 RESEARCH PAPER

> PRE-READING

CBS 2019 CBS 2019 FACULTY Education Resource CBSMD Scientific Library
Copyright ⓒ CBS MD Nanjing China. All rights reserved. 京ICP备16025898号-11
联系我们| Top