CBS - The 17th Left Main & Coronary Bifurcation Summit, CBS2025

科学研究

Outcomes after drug-coated balloon treatment for patients with calcified coronary lesions A Novel Familial Cardiac Arrhythmia Syndrome with Widespread ST-Segment Depression ACC/AATS/AHA/ASE/ASNC/HRS/SCAI/SCCT/SCMR/STS 2019 Appropriate Use Criteria for Multimodality Imaging in the Assessment of Cardiac Structure and Function in Nonvalvular Heart Disease: A Report of the American College of Cardiology Appropriate Use Criteria Task Force, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and the Society of Thoracic Surgeons Screening for Cardiovascular Disease Risk With Electrocardiography: US Preventive Services Task Force Recommendation Statement Percutaneous coronary intervention using a combination of robotics and telecommunications by an operator in a separate physical location from the patient: an early exploration into the feasibility of telestenting (the REMOTE-PCI study) Current Perspectives on Coronavirus Disease 2019 and Cardiovascular Disease: A White Paper by the JAHA Editors Digital learning and the future cardiologist Sudden Cardiac Arrest Survivorship: A Scientific Statement From the American Heart Association

Sort by hits |<<... 71 72 73 74 75 76 77 ...>>|

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.

Abstract

Recommended Article

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

ABSTRACT