Transthoracic Pulmonary Artery Denervation for Pulmonary Arterial Hypertension

Arteriosclerosis, Thrombosis, and Vascular Biology
Yuan HuangHao Zhang

Abstract

Objective- Pulmonary arterial hypertension is characterized by progressive pulmonary vascular remodeling and persistently elevated mean pulmonary artery pressures and pulmonary vascular resistance. We aimed to investigate whether transthoracic pulmonary artery denervation (TPADN) attenuated pulmonary artery (PA) remodeling, improved right ventricular (RV) function, and affected underlying mechanisms. We also explored the distributions of sympathetic nerves (SNs) around human PAs for clinical translation. Approach and Results- We identified numerous SNs in adipose and connective tissues around the main PA trunks and bifurcations in male Sprague Dawley rats, which were verified in samples from human heart transplant patients. Pulmonary arterial hypertensive rats were randomized into TPADN and sham groups. In the TPADN group, SNs around the PA trunk and bifurcation were completely and accurately removed under direct visualization. The sham group underwent thoracotomy. Hemodynamics, RV function, and pathological changes in PA and RV tissues were measured via right heart catheterization, cardiac magnetic resonance imaging, and pathological staining, respectively. Compared with the sham group, the TPADN group had lower mean pulmonary...Continue Reading

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Citations

May 23, 2019·Arteriosclerosis, Thrombosis, and Vascular Biology·Takeshi Ogo
Apr 25, 2020·JACC. Cardiovascular Interventions·Marc Pritzker
Nov 24, 2020·Current Cardiovascular Risk Reports·Jennalyn D MayeuxJohn J Ryan
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