Transcatheter pulmonary denervation in patients with left heart failure with reduced ejection fraction and combined precapillary and postcapillary pulmonary hypertension: A prospective single center experience.
Catheter Cardiovasc Interv
; 98(3): 588-594, 2021 09.
Article
in En
| MEDLINE
| ID: mdl-33559279
ABSTRACT
OBJECTIVES:
The present study was a prospective, single-center, single-arm study to investigate the efficacy of transcatheter pulmonary artery denervation (TPADN) in patients with combined postcapillary and precapillary PH (Cpc-PH) associated with left heart failure with reduced ejection fraction (HF-rEF).BACKGROUND:
Pulmonary hypertension (PH) in patients with left ventricular systolic dysfunction has a negative impact on outcome.METHODS:
The combination of pulmonary artery systolic pressure (PAPs) ≥60 mmHg, transpulmonary pressure gradient (TPG) ≥12 mmHg, nonreversible mean PAP, and pulmonary vascular resistance (PVR) ≥3.5 Wood Units was considered as too high risk for heart transplantation (HTx). The clinical efficacy endpoint was an improvement in 6-min walking test and the hemodynamic endpoints were changes in PAPs, PVR, and TPG between baseline and 6 months. Circumferential radiofrequency applications were delivered around distal main, left and right pulmonary arteries. At each ablation point temperature was 45°C and energy 10 W.RESULTS:
TPADN was performed in 10 patients. At 6-month in 5 patients we observed reduction in PAP, PVR, TPG, and DPG and then 1 had successful HTx, 2 are on HTx waiting list, 2 received LVADs, 2 patients did not improve, and 3 patients died.CONCLUSIONS:
TPADN may be beneficial in selected patients with HF-rEF and Cpc-PH.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Heart Failure
/
Hypertension, Pulmonary
Type of study:
Diagnostic_studies
/
Observational_studies
/
Risk_factors_studies
Limits:
Humans
Language:
En
Year:
2021
Type:
Article