Pulmonary artery denervation improves hemodynamics and cardiac function in pulmonary hypertension secondary to heart failure
This study aimed to determine the benefits and correlated mechanisms of pulmonary artery denervation (PADN) for heart failure (HF) pulmonary hypertension (PH). PH secondary to HF is associated with poor clinical outcomes because there is no proper therapy for it. PADN showed improved outcomes for pa...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2019-07-01
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| Series: | Pulmonary Circulation |
| Online Access: | https://doi.org/10.1177/2045894018816297 |
| _version_ | 1811228932856348672 |
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| author | Hang Zhang Wande Yu Juan Zhang Dujiang Xie Yue Gu Peng Ye Shao-Liang Chen |
| author_facet | Hang Zhang Wande Yu Juan Zhang Dujiang Xie Yue Gu Peng Ye Shao-Liang Chen |
| author_sort | Hang Zhang |
| collection | DOAJ |
| description | This study aimed to determine the benefits and correlated mechanisms of pulmonary artery denervation (PADN) for heart failure (HF) pulmonary hypertension (PH). PH secondary to HF is associated with poor clinical outcomes because there is no proper therapy for it. PADN showed improved outcomes for patients with HF-PH. However, the underlying mechanisms remain unknown. Supracoronary aortic banding (SAB) was used to create HF-PH models. Sprague-Dawley rats were randomly assigned to control, SAB, sham, SAB with PADN, and SAB without PADN groups. Surgical (longitudinally damaging vessel nerves) and chemical (10% phenol applied to the surface of nerves) PADN was performed for animals in the SAB with PADN group. Morphological, echocardiographic, hemodynamic, and protein expression changes were measured four weeks thereafter. Adrenergic receptor (AR) expressions of pulmonary arteries from four HF-PH patients and four patients without PH were measured. Ten HF-PH patients who underwent PADN were followed-up for six months. SAB-induced HF-PH was achieved by 50% of animals. Surgical and chemical PADN was associated with significant improvements in pulmonary artery muscularization, hemodynamics, and right ventricular functions. In pulmonary arterial specimens from HF-PH patients, β2-AR and α1A/B-AR, as well as eNOS, were downregulated and α1D-AR was upregulated compared to those from patients without PH. PADN led to a mean increase of 84 m during the 6-min walk distance for HF-PH patients at six-month follow-up. HF-PH was characterized by downregulated β2-AR, α1A-AR, and α1B-AR and by upregulated α1D-AR. PADN is associated with significant improvements in hemodynamics and pulmonary artery remodeling. |
| first_indexed | 2024-04-12T10:05:34Z |
| format | Article |
| id | doaj.art-9cd2b22ffac9432e8a02223e86998c55 |
| institution | Directory Open Access Journal |
| issn | 2045-8940 |
| language | English |
| last_indexed | 2024-04-12T10:05:34Z |
| publishDate | 2019-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Pulmonary Circulation |
| spelling | doaj.art-9cd2b22ffac9432e8a02223e86998c552022-12-22T03:37:27ZengWileyPulmonary Circulation2045-89402019-07-01910.1177/2045894018816297Pulmonary artery denervation improves hemodynamics and cardiac function in pulmonary hypertension secondary to heart failureHang Zhang0Wande Yu1Juan Zhang2Dujiang Xie3Yue Gu4Peng Ye5Shao-Liang Chen6Division of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, ChinaThird College, Nanjing Medical University, Nanjing, ChinaDivision of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, ChinaDivision of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, ChinaDivision of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, ChinaThird College, Nanjing Medical University, Nanjing, ChinaCollege of Pharmacy and Key Laboratory in Cooperative Innovational Center of Nanjing Medical University, Nanjing, ChinaThis study aimed to determine the benefits and correlated mechanisms of pulmonary artery denervation (PADN) for heart failure (HF) pulmonary hypertension (PH). PH secondary to HF is associated with poor clinical outcomes because there is no proper therapy for it. PADN showed improved outcomes for patients with HF-PH. However, the underlying mechanisms remain unknown. Supracoronary aortic banding (SAB) was used to create HF-PH models. Sprague-Dawley rats were randomly assigned to control, SAB, sham, SAB with PADN, and SAB without PADN groups. Surgical (longitudinally damaging vessel nerves) and chemical (10% phenol applied to the surface of nerves) PADN was performed for animals in the SAB with PADN group. Morphological, echocardiographic, hemodynamic, and protein expression changes were measured four weeks thereafter. Adrenergic receptor (AR) expressions of pulmonary arteries from four HF-PH patients and four patients without PH were measured. Ten HF-PH patients who underwent PADN were followed-up for six months. SAB-induced HF-PH was achieved by 50% of animals. Surgical and chemical PADN was associated with significant improvements in pulmonary artery muscularization, hemodynamics, and right ventricular functions. In pulmonary arterial specimens from HF-PH patients, β2-AR and α1A/B-AR, as well as eNOS, were downregulated and α1D-AR was upregulated compared to those from patients without PH. PADN led to a mean increase of 84 m during the 6-min walk distance for HF-PH patients at six-month follow-up. HF-PH was characterized by downregulated β2-AR, α1A-AR, and α1B-AR and by upregulated α1D-AR. PADN is associated with significant improvements in hemodynamics and pulmonary artery remodeling.https://doi.org/10.1177/2045894018816297 |
| spellingShingle | Hang Zhang Wande Yu Juan Zhang Dujiang Xie Yue Gu Peng Ye Shao-Liang Chen Pulmonary artery denervation improves hemodynamics and cardiac function in pulmonary hypertension secondary to heart failure Pulmonary Circulation |
| title | Pulmonary artery denervation improves hemodynamics and cardiac function in pulmonary hypertension secondary to heart failure |
| title_full | Pulmonary artery denervation improves hemodynamics and cardiac function in pulmonary hypertension secondary to heart failure |
| title_fullStr | Pulmonary artery denervation improves hemodynamics and cardiac function in pulmonary hypertension secondary to heart failure |
| title_full_unstemmed | Pulmonary artery denervation improves hemodynamics and cardiac function in pulmonary hypertension secondary to heart failure |
| title_short | Pulmonary artery denervation improves hemodynamics and cardiac function in pulmonary hypertension secondary to heart failure |
| title_sort | pulmonary artery denervation improves hemodynamics and cardiac function in pulmonary hypertension secondary to heart failure |
| url | https://doi.org/10.1177/2045894018816297 |
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