News | Hypertension | October 04, 2018

Pulmonary Artery Denervation Significantly Improvements Hemodynamics in CpcPH

A randomized trial of pulmonary artery denervation in patients with combined pre- and postcapillary pulmonary hypertension

 Pulmonary artery denervation for CpcPH from the PADN-5 trial. #TCT2017

A series of procedural images of a pulmonary artery denervation for CpcPH from the PADN-5 trial.


October 4, 2018 — Pulmonary artery denervation (PADN) is associated with significant improvements in hemodynamic and clinical outcomes in patients with capillary pulmonary hypertension (CpcPH). This was the result of the late-breaking PADN-5 trial presented at the 2018 Transcatheter Cardiovascular Therapeutics (TCT) symposium.

The randomized trial PADN in patients with combined pre- and post-capillary pulmonary hypertension was presented by Shao-Liang Chen, M.D., Division of Cardiology, Nanjing First Hospital Nanjing Medical University, Nanjing, China. PADN has been shown to improve hemodynamics of pulmonary arterial hypertension (PAH) in a series of patients. Additionally, benefits of targeted medical therapy in these patients for patients secondary to left sided heart failure was unknown. The objective was to assess the benefits of PADN among CpcPH patients in a prospective, randomized sham-controlled trial.

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.

At six-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.

See the slides presented at TCT 2018 for this trial.

Find links to the TCT 2018 Late-breaking Cardiovascular Clinical Trials and Videos
 

 

 

Reference:

1. Hang Zhang, Juan Zhang, Mengxuan Chen, et al. 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. JACC: Cardiovascular Interventions. September 2018. DOI: 10.1016/j.jcin.2018.09.021
 


Related Content

News | Cardiovascular Clinical Studies

September 8, 2022 — A clinical trial led by investigators from Brigham and Women’s Hospital has found that the long-term ...

Home September 08, 2022
Home
News | Cardiovascular Clinical Studies

August 17, 2022 — A study carried out by scientists at the Centro Nacional de Investigaciones Cardiovasculares (CNIC) ...

Home August 17, 2022
Home
News | Cardiovascular Clinical Studies

August 12, 2022 — Older adults with atrial cardiopathy (a major, often undetected cardiac cause of stroke) may be at ...

Home August 12, 2022
Home
News | Cardiovascular Clinical Studies

August 8, 2022 — Two years ago, University of Alabama at Birmingham researchers and colleagues reported that reductive ...

Home August 08, 2022
Home
News | Cardiovascular Clinical Studies

July 22, 2022 — BioSig Technologies, Inc. a medical technology company advancing electrophysiology workflow by ...

Home July 22, 2022
Home
News | Cardiovascular Clinical Studies

July 18, 2022 — scPharmaceuticals Inc., a pharmaceutical company focused on developing and commercializing products that ...

Home July 19, 2022
Home
News | Cardiovascular Clinical Studies

July 15, 2022 — Imagine, if scientists had a map of the heart, so granular in its accuracy that it even profiled details ...

Home July 15, 2022
Home
News | Cardiovascular Clinical Studies

July 11, 2022 — Smoking traditional or non-combustible cigarettes while wearing a surgical mask results in a two-fold ...

Home July 12, 2022
Home
News | Cardiovascular Clinical Studies

June 24, 2022 — Henry Ford Health was part of a multi-institutional heart failure study that was launched and executed ...

Home June 24, 2022
Home
News | Cardiovascular Clinical Studies

June 21, 2022 — Renibus Therapeutics (“Renibus”), a clinical-stage biotech company focusing on the prevention and ...

Home June 21, 2022
Home
Subscribe Now