The progress of pulmonary artery denervation
Yonghui Xie, Na Liu, Zhenghui Xiao, Fang Yang, Yunhong Zeng, Zhou Yang, Yuanxi Xia, Zhi Chen, Yunbin Xiao
Abstract
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.