Response to Letter Regarding Article, “Hemodynamic, Functional, and Clinical Responses to Pulmonary Artery Denervation in Patients With Pulmonary Arterial Hypertension of Different Causes: Phase II Results From the Pulmonary Artery Denervation-1 Study”

HomeCirculation: Cardiovascular InterventionsVol. 9, No. 1Response to Letter Regarding Article, "Hemodynamic, Functional, and Clinical Responses to Pulmonary Artery Denervation in Patients With Pulmonary Arterial Hypertension of Different Causes: Phase II Results From the Pulmonary Artery Denervation-1 Study" Free AccessLetterPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessLetterPDF/EPUBResponse to Letter Regarding Article, "Hemodynamic, Functional, and Clinical Responses to Pulmonary Artery Denervation in Patients With Pulmonary Arterial Hypertension of Different Causes: Phase II Results From the Pulmonary Artery Denervation-1 Study" Shao-Liang Chen, MD Hang Zhang, MD, Du-Jiang Xie, MD and Juan Zhang, MD Ling Zhou, MD Alexander M.K. Rothman, MD Gregg W. Stone, MD Shao-Liang ChenShao-Liang Chen Division of Cardiology Nanjing First Hospital Nanjing Medical University Nanjing, China Hang ZhangHang Zhang Division of Cardiology Nanjing Heart Center Nanjing, China , Du-Jiang XieDu-Jiang Xie Division of Cardiology Nanjing Heart Center Nanjing, China and Juan ZhangJuan Zhang Division of Cardiology Nanjing Heart Center Nanjing, China Ling ZhouLing Zhou Division of Cardiology Nanjing First Hospital Nanjing Medical University Nanjing, China Alexander M.K. RothmanAlexander M.K. Rothman Department of Cardiovascular Science University of Sheffield Sheffield, United Kingdom Gregg W. StoneGregg W. Stone Division of Cardiology Columbia University Medical Center and the Cardiovascular Research Foundation New York, NY Originally published11 Jan 2016https://doi.org/10.1161/CIRCINTERVENTIONS.115.003463Circulation: Cardiovascular Interventions. 2016;9We read with interest the letter by Hoeper and Galiè,1 which raised several concerns about our article2 recently published in Circulation: Cardiovascular Interventions.As we described in Pulmonary Artery Denervation-1 (PADN-I) study,3 the withdrawal of target drugs for pulmonary arterial hypertension was based on the clinical and hemodynamic measurements when patients had taken these targeted therapies for several years. A reason seemed to be ethical.In terms of 12% all-cause mortality at 1-year follow-up after pulmonary artery denervation, the result is not surprising mainly because (1) most patients had been put on maximal medication for several years, without significant improvement in clinical and hemodynamic variables, indicating that patients were at high risk of death, (2) 18 patients had pulmonary hypertension secondary to left heart failure (15 with previous myocardial infarction and 3 with dilated cardiomyopathy). We have realized this number of mortality; however, it is too earlier to question that this number is too high when compared with medication because of no control group in our analysis. Again, some target drugs are toxic to patients with pulmonary arterial hypertension.To shorten the article length, we only used group II pulmonary arterial hypertension to indicate pulmonary hypertension secondary to left heart failure. For this point, we put pulmonary hypertension secondary to left ventricular dysfunction after group II pulmonary arterial hypertension in the content. Frequent description of prostaglandin was intended to treat the left heart failure, not only focusing on pulmonary hypertension.Yes, to further assess the clinical efficacy of pulmonary artery denervation, serial randomized clinical studies are required in future.Shao-Liang Chen, MDDivision of Cardiology Nanjing First Hospital Nanjing Medical University Nanjing, ChinaHang Zhang, MDDu-Jiang Xie, MDJuan Zhang, MDDivision of Cardiology Nanjing Heart Center Nanjing, ChinaLing Zhou, MDDivision of Cardiology Nanjing First Hospital Nanjing Medical University Nanjing, ChinaAlexander M.K. Rothman, MDDepartment of Cardiovascular Science University of Sheffield Sheffield, United Kingdom,Gregg W. Stone, MDDivision of Cardiology Columbia University Medical Center and the Cardiovascular Research Foundation New York, NYDisclosuresNone.References1. Hoeper MM, Galiè N. Letter by Hoeper and Galiè regarding article, "Hemodynamic, functional, and clinical responses to pulmonary artery denervation in patients with pulmonary arterial hypertension of different causes: phase II results from the Pulmonary Artery Denervation-1 study."Circ Cardiovasc Interv. 2016; 9:e003422. doi: 10.1161/CIRCINTERVENTIONS.115.003422.LinkGoogle Scholar2. Chen SL, Zhang H, Xie DJ, Zhang J, Zhou L, Rothman AM, Stone GW. Hemodynamic, functional, and clinical responses to pulmonary artery denervation in patients with pulmonary arterial hypertension of different causes: phase II results from the Pulmonary Artery Denervation-1 study.Circ Cardiovasc Interv. 2015; 8:e002837. doi: 10.1161/CIRCINTERVENTIONS.115.002837.LinkGoogle Scholar3. Chen SL, Zhang FF, Xu J, Xie DJ, Zhou L, Nguyen T, Stone GW. Pulmonary artery denervation to treat pulmonary arterial hypertension: the single-center, prospective, first-in-man PADN-1 study (first-in-man pulmonary artery denervation for treatment of pulmonary artery hypertension).J Am Coll Cardiol. 2013; 62:1092–1100. doi: 10.1016/j.jacc.2013.05.075.CrossrefMedlineGoogle Scholar Previous Back to top Next FiguresReferencesRelatedDetails January 2016Vol 9, Issue 1 Advertisement Article InformationMetrics © 2016 American Heart Association, Inc.https://doi.org/10.1161/CIRCINTERVENTIONS.115.003463PMID: 26755574 Originally publishedJanuary 11, 2016 PDF download Advertisement SubjectsHeart FailurePeripheral Vascular DiseasePulmonary Hypertension