Cai Xingxing, Wei Zhixing, Shen Yichen, Qian Li, Cai Jing, Yang Yuli, Chi Runmin, Wang Wei, Yu Shunxuan, Li Keke, Fei Yudong, Li Cheng, Han Yaqin, Liu Ming, Zhang Jianguo, Wang Dengbin, Jiang Mawei, Li Yi-Gang
Department of Cardiology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
Department of Oncology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
Nat Commun. 2025 Jan 9;16(1):558. doi: 10.1038/s41467-025-55933-8.
Catheter-based pulmonary artery denervation (PADN) has achieved promising outcomes to treat pulmonary hypertension (PH). We herein present stereotactic body radiotherapy (SBRT) as a novel noninvasive approach for PADN. A single fraction of 15 Gy, 20 Gy or 25 Gy was delivered for PADN in a thromboxane A2 (TxA2) - induced acute PH swine model. We demonstrated that PADN by 20-Gy SBRT reduced mean pulmonary artery (PA) pressure during the TxA2 challenge. All SBRT dosages led to a deeper denervation area compared with radiofrequency ablation (RFA) and reduced sympathetic neural norepinephrine synthesis in the ablation zone. Probable radiation related side effects were mostly found in animals treated with 25-Gy. In subsequent monocrotaline-induced chronic PH animals, PADN by 20-Gy SBRT resulted in more significant improvement in pulmonary hemodynamics and PA remodeling in comparison to RFA. In summary, our findings suggest that appropriate SBRT scheme could balance the efficacy and safety for PADN, potentiating to be a novel strategy to treat PH.
基于导管的肺动脉去神经支配术（PADN）在治疗肺动脉高压（PH）方面已取得了令人鼓舞的成果。我们在此介绍立体定向体部放疗（SBRT）作为一种用于PADN的新型非侵入性方法。在血栓素A2（TxA2）诱导的急性PH猪模型中，单次给予15 Gy、20 Gy或25 Gy进行PADN。我们证明，20 Gy的SBRT进行PADN可在TxA2激发期间降低平均肺动脉（PA）压力。与射频消融（RFA）相比，所有SBRT剂量均导致去神经支配区域更深，并减少了消融区内交感神经去甲肾上腺素的合成。可能的辐射相关副作用大多出现在接受25 Gy治疗的动物中。在随后的野百合碱诱导的慢性PH动物中，与RFA相比，20 Gy的SBRT进行PADN可使肺血流动力学和PA重塑得到更显著的改善。总之，我们的研究结果表明，合适的SBRT方案可以平衡PADN的疗效和安全性，有望成为治疗PH的一种新策略。
Zotero 插件
