Academy of Pediatrics, University of South China, Changsha, China.
Department of Cardiology, Hunan Children's Hospital, Changsha, China.
Cardiol J. 2022;29(3):381-387. doi: 10.5603/CJ.a2020.0186. Epub 2021 Jan 13.
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.
肺动脉高压（PAH）是一种慢性肺血管疾病，其特征是肺动脉压力升高和肺小动脉重构。一些研究发现了交感神经（SNs）与 PAH 发病机制之间的关系。本综述旨在阐明肺动脉中 SNs 的位置和组成，以及肺动脉去神经支配（PADN）的不同方法和效果。研究表明，SNs 主要分布在主肺动脉和肺动脉分叉周围。SNs 可以通过三种方式被破坏：化学方法、手术方法和基于导管的方法。PADN 可迅速显著降低肺动脉压，改善血液动力学变化，从而缓解 PAH。PADN 已被认为是 PAH 患者的一种有前途且有效的治疗方法，特别是对于那些对药物难治性 PAH 的患者。然而，需要进一步扩大临床研究来确定 SNs 在肺动脉中的准确分布和 PADN 的疗效。
