PMID- 37121454
OWN - NLM
STAT- MEDLINE
DCOM- 20231023
LR  - 20231023
IS  - 1535-6280 (Electronic)
IS  - 0146-2806 (Linking)
VI  - 48
IP  - 9
DP  - 2023 Sep
TI  - Pulmonary Artery Denervation as a New Therapeutic Option for Pulmonary 
      Hypertension: A Systematic Review and Meta-Analysis.
PG  - 101776
LID - S0146-2806(23)00193-7 [pii]
LID - 10.1016/j.cpcardiol.2023.101776 [doi]
AB  - Pulmonary hypertension (PH) is a progressive disease with a high morbidity and 
      mortality. The treatment is based on the type of PH. Prognosis still remains poor 
      despite the use of different medications. Pulmonary artery denervation (PADN) has 
      been studied as a novel therapeutic option in these patients. PUBMED, EMBASE and 
      COCHRANE databases were searched by 2 investigators until January 2023. 
      Information was analyzed for the following outcomes: 6-minute walk distance 
      (6MWD), mean pulmonary artery pressure, pulmonary vascular resistance and cardiac 
      output. Subgroup analysis comparing pre and post PADN in different PH groups was 
      done. Statistical analysis was performed with the Review Manager version 5.4. 
      This meta- analysis included 6 controlled trials and 6 single-arm prospective 
      studies with a total of 616 patients. Our pooled analysis showed a significant 
      reduction in mean pulmonary artery pressure [WMD -6.51, 95% CI (-9.87, -3.15), 
      p = 0.0001], pulmonary vascular resistance [WMD -3.69, 95% CI (-6.74, -0.64), 
      p = 0.02] and increased cardiac output [WMD -0.37, 95% CI (0.08, 0.65), 
      p = 0.01]. Subgroup analysis pre and post PADN demonstrated a significant 
      improvement in 6MWD in the WHO group 1 [WMD 99.53, 95% CI (19.60, 179.47), 
      p = 0.01], group 2 [WMD: 69.96, 95% CI (36.40, 103.51), p = < 0.0001] and group 4 
      [WMD: 99.54, 95% CI (21.80, 177.28), p = 0.01]. This meta-analysis supports PADN 
      as a therapeutic option for patients with PH, regardless of group class. Further 
      randomized trials are still needed to evaluate safety and efficacy.
CI  - Copyright (c) 2023 Elsevier Inc. All rights reserved.
FAU - Salazar, Adolfo Martinez
AU  - Salazar AM
AD  - Division of Internal Medicine, Department of Medicine, Michigan State University, 
      East Lansing, Michigan. Electronic address: mart2580@msu.edu.
FAU - Al-Asad, Khalid Saeed
AU  - Al-Asad KS
AD  - Division of Internal Medicine, Department of Medicine, Michigan State University, 
      East Lansing, Michigan.
FAU - Prasad, Rohan M
AU  - Prasad RM
AD  - Department of Cardiology, Michigan State University, East Lansing, Michigan.
FAU - Panama, Gabriel
AU  - Panama G
AD  - Division of Internal Medicine, Department of Medicine, Michigan State University, 
      East Lansing, Michigan.
FAU - Banga, Sandeep
AU  - Banga S
AD  - Department of Cardiology, Michigan State University, East Lansing, Michigan.
FAU - Wilcox, Matthew
AU  - Wilcox M
AD  - Department of Cardiology, Thoracic Cardiovascular Institute, Sparrow Hospital, 
      Lansing, Michigan.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20230429
PL  - Netherlands
TA  - Curr Probl Cardiol
JT  - Current problems in cardiology
JID - 7701802
SB  - IM
MH  - Humans
MH  - *Hypertension, Pulmonary/surgery/drug therapy
MH  - Pulmonary Artery/surgery
MH  - Prospective Studies
MH  - Denervation
COIS- Declaration of Competing Interest The authors have no conflicts of interest to 
      disclose.
EDAT- 2023/05/01 00:41
MHDA- 2023/10/23 12:42
CRDT- 2023/04/30 19:27
PHST- 2023/04/18 00:00 [received]
PHST- 2023/04/26 00:00 [accepted]
PHST- 2023/10/23 12:42 [medline]
PHST- 2023/05/01 00:41 [pubmed]
PHST- 2023/04/30 19:27 [entrez]
AID - S0146-2806(23)00193-7 [pii]
AID - 10.1016/j.cpcardiol.2023.101776 [doi]
PST - ppublish
SO  - Curr Probl Cardiol. 2023 Sep;48(9):101776. doi: 10.1016/j.cpcardiol.2023.101776. 
      Epub 2023 Apr 29.