Pulmonary artery denervation for pulmonary hypertension: a systematic review and meta-analysis of clinical studies

Q4 Medicine

Arterial Hypertension (Russian Federation) Pub Date : 2022-03-17 DOI:10.18705/1607-419x-2021-27-6-628-641

L. Korobchenko, N. Goncharova, H. I. Condori Leandro, A. Vakhrushev, E. Andreeva, O. Moiseeva, E. N. Mikhaylov

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引用次数: 0

Abstract

Objective. To analyze the results of clinical studies on pulmonary artery denervation (PADN) for pulmonary hypertension treatment.Design and methods. Study search was conducted in PubMed/Medline, Cochrane, Elibrary databases. The analysis included studies of surgical and transcatheter PADN. To assess the effectiveness of the PADN procedure, a mean pulmonary artery pressure (mPAP) and a 6-minute walk test distance (6-MWT) were selected. For each study, the mean change in mPAP and 6-MWT were calculated and included in the analysis.Results. A total of 8 studies were analyzed: 4 randomized and 4 observational, 320 patients were included in the study, of which 222 patients underwent PADN. The etiology of pulmonary hypertension (PH) was different in each study and included patients with idiopathic PH, PH associated with heart failure, chronic thromboembolic PH. According to the combined data analysis, mPAP decreased in all studies, and the overall change in mPAP was –8,59 [95 % confidence interval (CI) –10,96; –6,23]. The average increase in 6-MWT among studies was 60,00 [95 % CI 35,74; 84,27].Conclusions. Despite serious limitations (a small number of studies and subjects enrolled, non-randomized design of a half of the studies, high heterogeneity of data), this analysis demonstrated the association of the PADN procedure with a decrease in pulmonary artery pressure and prolongation of the 6-minute walking distance in patients with PH of various etiologies.

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肺动脉去神经支配治疗肺动脉高压:临床研究的系统回顾和荟萃分析

目标。目的分析肺动脉去神经支配治疗肺动脉高压的临床研究结果。设计和方法。研究检索在PubMed/Medline, Cochrane, library数据库中进行。分析包括手术和经导管PADN的研究。为了评估PADN手术的有效性，我们选择了平均肺动脉压(mPAP)和6分钟步行测试距离(6-MWT)。对于每项研究，计算mPAP和6-MWT的平均变化并将其纳入分析。共分析8项研究:4项随机研究和4项观察研究，共纳入320例患者，其中222例患者接受了PADN。肺动脉高压(PH)的病因在每项研究中都不同，包括特发性PH、PH与心力衰竭相关、慢性血栓栓塞性PH。根据综合数据分析，所有研究的mPAP均下降，mPAP的总体变化为- 8,59[95%置信区间(CI) - 10,96;6日,23)。研究中6-MWT的平均增加为60000例[95% CI 35,74;84年,27].Conclusions。尽管存在严重的局限性(研究和受试者数量较少，一半研究的非随机设计，数据的高度异质性)，该分析表明，PADN手术与各种病因的PH患者肺动脉压降低和6分钟步行距离延长有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Arterial Hypertension (Russian Federation) Medicine-Cardiology and Cardiovascular Medicine

CiteScore

0.90

自引率

0.00%

发文量

期刊介绍： The main aims of the Journal include collecting and generalizing the knowledge in hypertensiology; education and professional development of cardiologists and medical doctors of other specialties, who deal with different issues regarding diagnostics, management and prevention of hypertension in both clinical practice and research. The Journal also calls attention to the most urgent and up-to-date questions in hypertensiology, cardiology and related sciences. There are additional objectives, such as increasing the availability, accessibility and recognition of Russian medical scientific achievements at the international level by improving the quality of the publication and the way they are presented; enabling the exchange of opinions and information between scientists and their wider communication. The main criteria for publication selection fit with the mentioned objectives and include currency, singularity, scientific and practical novelty, applied relevance etc.