Department of cardiology, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing, 210006, Jiangsu, China.
Curr Cardiol Rep. 2019 Sep 5;21(10):124. doi: 10.1007/s11886-019-1203-z.
Sympathetic overactivity plays an important role in the progression of pulmonary arterial hypertension (PAH). The purpose of this review is to illustrate localization of pulmonary arterial sympathetic nerves, the key steps of pulmonary artery denervation (PADN) procedure, and to highlight clinical outcomes.
Sympathetic nerves mostly occurred in the posterior region of the bifurcation and pulmonary trunk. Emerging preclinical data provided the potential of PADN for PAH. PADN, produced at bifurcation area, improved a profound reduction of pulmonary arterial pressure and ameliorated clinical outcomes with an exclusive ablation catheter. The application of PADN in the patients of PAH or combined pre-capillary and post-capillary PH (CpcPH) improved the hemodynamic parameters and increased 6MWD. Sympathetic overactivity aggravates PAH. PADN is a promising interventional treatment for PAH and CpcPH. Additional clinical trials are warranted to confirm the efficacy of PADN.
交感神经过度活跃在肺动脉高压（PAH）的进展中起重要作用。本文旨在阐述肺动脉交感神经的定位、肺动脉去神经术（PADN）的关键步骤，并强调临床结果。
交感神经主要存在于分叉和肺动脉干的后区。新兴的临床前数据为 PAH 的 PADN 提供了潜在的可能。在分叉区进行 PADN 可显著降低肺动脉压，并通过专用消融导管改善临床结果。在 PAH 或混合前毛细血管和后毛细血管 PH（CpcPH）患者中应用 PADN 可改善血流动力学参数并增加 6MWD。交感神经过度活跃会加重 PAH。PADN 是一种有前途的 PAH 和 CpcPH 的介入治疗方法。需要进一步的临床试验来证实 PADN 的疗效。
