In Vivo Canine Study Shows Percutaneous Pulmonary Artery Denervation Abolishes Experimental Pulmonary Arterial Hypertension

March 7, 2013—Shao-Liang Chen, MD, et al have published findings from an in vivo canine study that sought to assess the effect of percutaneous pulmonary artery denervation (PADN) on balloon-occlusion-induced acute pulmonary arterial hypertension. PADN is a catheter-based interventional therapy using radiofrequency ablation to abolish the pulmonary arterial baroreceptors to pressure response. The study is available online ahead of print in EuroIntervention.

As summarized in EuroIntervention, to examine the efficacy of balloon-occlusion-induced pulmonary arterial hypertension, the investigators randomly assigned 20 Mongolian dogs to one of two groups: group 1 (left distal pulmonary basal trunk occlusion) and group 2 (left pulmonary interlobar artery occlusion). Afterwards, PADN treatment was conducted at the main pulmonary artery bifurcation level with left pulmonary interlobar artery occlusion in all 20 dogs.

The investigators measured hemodynamic parameters at baseline and during balloon occlusion as well as the PADN treatment at different time points: 1, 2, 3, 5, and 10 minutes. Before the PADN treatment, most hemodynamic parameters of the pulmonary artery remained unchanged in group 1 with distal pulmonary basal trunk occlusion. However, in group 2 with the occlusion of the left pulmonary interlobar artery, mean pulmonary arterial pressure, mean right ventricular pressure, and pulmonary vessel resistance gradually increased, and mean absolute difference reached peak at 5 minutes (Δ16.6 mmHg, Δ14.1 mmHg, and Δ1,144 dye/s/cm⁵, respectively; each P < .01). These hemodynamic parameters at 5 minutes induced by left pulmonary interlobar artery occlusion were completely abolished with the PADN treatment compared to baseline (Δ0.3 mmHg, Δ0.2 mmHg, and Δ34 dye/s/cm⁵, respectively).

The investigators concluded that balloon occlusion of the left pulmonary interlobar artery led to a significant increase of hemodynamic parameters of the pulmonary artery. The pressure responses were completely abolished by the PADN treatment at the main bifurcation area of the left pulmonary artery, reported the investigators in EuroIntervention.