Abstract 18284: The Significant Improvement of Cardiac Function After Pulmonary Artery Denervation Procedure in Patients With Pulmonary Arterial Hypertension
Background: Based on our preliminary experience with performing pulmonary artery denervation (PADN) on patients (pts) with idiopathic pulmonary arterial hypertension (IPAH), we started to perform PADN on patients with PAH that is secondary to a variety of cardiac disorders and not responding to medical therapy. We used echocardiography (Echo) to assess the improvement of cardiac function post PADN.
Methods: Seventy one pts with PAH were studied. The etiology of their PAH were, idiopathic (39), connective tissue disease (10), hypertension (7), dilated cardiomyopathy (14) and one patient with chronic thromboembolic pulmonary hypertension. Transthorathic Echo was performed on all patents, before, 1-week, 3-, 6- and 12-month after PADN. The longitudinal strain of right ventricular (RVLS) free wall and septum as well as LV global wall (LVLS) was analyzed (EchoPac), tricuspid annulus plane systolic excursion (TAPSE), routing 2D and Doppler parameters were measured. Pulmonary vascular resistance (PVR) was calculated.
Results: The pts’ mean age was 51±16 years, 32 (45 %) were male. We define effectiveness of the treatment as LVLS, RVLS improved ≧-3%, TAPS increased 3 mm, and PVR reduced 2W comparing with baseline, at 1 week, 3-, 6- and 12-month follow-up. The patients’ cardiac function and PVR showed significant improvement ( 59, 78, 71and 69 % at 1 week, 3-, 6- and 12 -month time points respectively) after PADN. These results were consistent with the pts’ physical improvement, assessed by 6 minute walk distance (MWD) (Table). Figure showed the RVLS improvement in 1 case (A.Before and B. 6-month post PADN).
Conclusions: Our results indicated that PADN is not only effective in pts with IPAH, but also effective in pts with a variety of secondary PAH not responding to medical therapy. Further randomized study is necessary to find the optimal indications for PADN and further confirm its efficacy.
Author Disclosures: J. Sun: None. J. Zhang: None. Z. Hu: None. Y. Liu: None. J. Du: None. H. Zhang: None. F. Zhang: None. B.P. Yan: None. G.W. Stone: None. S. Chen: None.
- © 2016 by American Heart Association, Inc.