Pulmonary vessels are densely innervated by sympathetic, parasympathetic, and sensitive fibers. According to the World Health Organization (WHO) pulmonary arterial hypertension (PAH) grade 1 consists of obliterating pulmonary vascular remodeling accompanied by a diminished generation of vessel dilators. Its pharmacological treatment has certain limitations and sympathetic pulmonary vascular denervation might be a valid treatment alternative,...
Jorge Oseguera Moguel 2012-08-09
Título original: Riociguat for the Treatment of Pulmonary Arterial Hypertension. Referencia: Hossein-Ardeschir Ghofrani et al. N Engl J Med 2013;369:330-40. Many drugs have been tested for pulmonary arterial hypertension (PAH) including PDE5 inhibitors, prostanoids and endothelin receptor antagonists, however there are still missed targets in the treatment of this disease. Riociguat is a drug belonging to a...
Primary Pulmonary Hypertension is behind multiple hospitalizations and pulmonary transplants. Even though its treatment has been advanced, many patients will not respond well. The PADN-CFDA randomized 128 patients, 63 received pulmonary denervation (PADN) and 65 went to the control group. Primary end point was 6-minute walk distance test at 6 months. The populations were similar,...
This work included 98 patients with pre- and post-capillary pulmonary hypertension defined as mean pulmonary arterial pressures ≥25 mmHg, pulmonary capillary wedge pressures >15 mmHg, and pulmonary vascular resistance >3.0 Wood units. These subjects were randomized to pulmonary artery denervation vs. sildenafil plus sham pulmonary artery denervation. The medical treatment for heart failure was administered to all patients. The...
The European guidelines on hypertension have been updated and now feature differences compared with American guidelines regarding how to diagnose and treat patients with high blood pressure. The main difference particularly lies in how aggressive physicians should be in lowering blood pressure. These data are available from a preview of the document presented at the...
Thromboembolic pulmonary hypertension is caused by pulmonary artery stenosis caused by organized thrombi. The only treatment potentially healing for this disease is surgical thrombectomy. However, patients with lesions in very peripheral branches or high surgical risk patients with comorbidities might benefit from a plan B, such as balloon pulmonary angioplasty. The percentage of patients with chronic...
Original Title: Hemodynamic. Functional and Clinical Responses to Pulmonary Artery Denervation with Pulmonary Artery Hypertension of Different Causes. Phase II Results from the Pulmonary Artery Denervation 1 study. Reference: Circ Cardiovasc Interv. 2015;8 Courtesy of Dr. Guillermo Migliaro. Hospital Alemán, Buenos Aires, Argentina. The mechanisms responsible for pulmonary artery hypertension (PAH) are multifactorial. PAH reduces...
Previous studies have shown that renal denervation in a 3-year period, reduced the blood pressure in resistant hypertensive patients in a sustained and meaningful way. The aim of this study was to evaluate this therapy in a larger number of patients with the control group receiving “sham” (renal angiography conscious sedation) procedure. Patients and the...
Original title: Pulmonary artery denervation to treat pulmonary arterial hypertension: a single center, prospective, first-in-man PADN-1 study. Reference: Shao-Liang Chen et al. J Am Coll Cardiol. Article in press. Idiopathic pulmonary hypertension is characterized by elevated mean pressure and resistance due to an imbalance between local vasodilator and vasoconstrictor added to the vascular wall renovation. Based on animal...