Clinical and Hemodynamic Effects of Pulmonary Artery Denervation in Pulmonary Hypertension Despite Optimized Pharmacotherapy: An Updated Systematic Review and Meta-Analysis
Abstract
Background: Pulmonary hypertension (PH) remains a progressive and life-threatening condition despite advances in targeted pharmacotherapy. Pulmonary artery denervation (PADN) has emerged as a novel interventional strategy aimed at modulating sympathetic overactivity and improving pulmonary vascular hemodynamics. Methods: A comprehensive search of PubMed, EMBASE, Scopus, Web of Science, and the Cochrane Library was conducted through December 2024. Randomized clinical trials and prospective observational studies assessing PADN in PH were included. Primary endpoints were changes in outcomes from six-minute walk distance (6MWD), mean pulmonary artery pressure (mPAP), pulmonary vascular resistance (PVR), cardiac output (CO), and right ventricular function parameters. Secondary outcomes included clinical worsening, rehospitalization, transplantation, and all-cause mortality. Random-effects models were used to calculate pooled mean differences (MDs) and odds ratios (ORs) with 95% confidence intervals (CIs). Subgroup analyses were performed according to pulmonary hypertension phenotype and study design, and sensitivity analyses were conducted to assess robustness of pooled estimates. Results: Nine studies involving 454 patients were included. PADN significantly improved functional capacity (6MWD: MD = 92.03 m; 95% CI 46.37-137.68; p p p p p = 0.001) and rehospitalization (OR = 0.07; p p = 0.12). Considerable heterogeneity was observed across functional and hemodynamic outcomes,…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 454 participants or records.
Read the paper
Related studies
- 2024 update in heart failure
- Vascular involvement in idiopathic pulmonary fibrosis
- A novel technique- subendometrial autologous platelet rich plasma injection in patients with unresponsive thin endometrium undergoing frozen-thawed embryo transfer: a prospective cohort study
- Does metformin prolong pregnancy in preterm pre-eclampsia? A study protocol for a South African, hospital-based double-blind, randomised, placebo-controlled trial
- Combined Pulmonary Fibrosis and Emphysema (CPFE): A "New" Smoking-Related Interstitial Lung Disease (ILD)
- Impact of an acute 1-month cannabidiol treatment on pain and inflammation after a long bone fracture: a triple-blind randomised, placebo-controlled, clinical trial protocol
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.