The progress of pulmonary artery denervation

Cardiol J. 2022;29(3):381-387. doi: 10.5603/CJ.a2020.0186. Epub 2021 Jan 13.

Abstract

Pulmonary arterial hypertension (PAH) is a chronic pulmonary vascular disease characterized by increased pulmonary arterial pressure and pulmonary arterioles remodeling. Some studies have discovered the relationship between sympathetic nerves (SNs) and pathogenesis of PAH. This review is aimed to illustrate the location and components of SNs in the pulmonary artery, along with different methods and effects of pulmonary artery denervation (PADN). Studies have shown that the SNs distributed mainly around the main pulmonary artery and pulmonary artery bifurcation. And the SNs could be destroyed by three ways: the chemical way, the surgical way and the catheter-based way. PADN can significantly decrease pulmonary arterial pressure rapidly, improve hemodynamic varieties, and then palliate PAH. PADN has been recognized as a prospective and effective therapy for PAH patients, especially for those with medication-refractory PAH. However, further enlarged clinical studies are needed to confirm accurate distribution of SNs in the pulmonary artery and the efficacy of PADN.

Keywords: pulmonary arterial hypertension; pulmonary artery denervation; sympathetic nerves.

Publication types

  • Review

MeSH terms

  • Humans
  • Hypertension, Pulmonary*
  • Prospective Studies
  • Pulmonary Arterial Hypertension*
  • Pulmonary Artery / surgery
  • Sympathectomy / adverse effects

Grants and funding

This work was supported by Hunan Provincial Key Laboratory of Emergency Medicine for Children (grant 2018TP1028), Project of Hunan Provincial Research on Chinese Medicine (grant 201914), Hunan Provincial Natural Science Youth Foundation of China (grant 2019JJ50881), Hunan Provincial Innovation Foundation For Postgraduate (grant CX20200984) and Hunan Provincial Health Commission project (grant 20200587 and 20200596).