New ideas for transthoracic pulmonary artery denervation for pulmonary arterial hypertension

2019-03-28

Funded by Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences (CIFMS 2017-IZM-1-00 and CIFMS 2016-I2M-4-003) and National Science Fund for Distinguished Young Scholars (81525002), Zhang Hao and his team from State Key Laboratory of Cardiovascular Disease, Fuwai Hospital under Chinese Academy of Medical Sciences, through cooperation with Jing Zhicheng from State Key Laboratory of Pulmonary Vascular Disease under Chinese Academy of Medical Sciences, Yang Juan from Institute of Basic Medical Sciences under Chinese Academy of Medical Sciences, put forward a new idea to cure pulmonary arterial hypertension on the internationally recognized vascular physiology journal Arteriosclerosis, Thrombosis, and Vascular Biology. It was recommended by the journal as the Cover Story of that issue.

 

 

 

Pulmonary arterial hypertension (PAH) is a rare disease and its progression is hardly to be reversed via conventional medical treatment or multidisciplinary targeted medication. Consequently, the patients with PAH will have a poor quality of life in the long run and a high death rate.  Thus, a more effective treatment is in urgent need.

 

 

 

By analyzing the innervation of pulmonary arteries of rat and human, the research group found that there were a great number of sympathetic nerve fibers in the connective tissues in the main pulmonary artery and its bifurcation area. Later, the group used two SU5416/hypoxia induced and monocrotaline induced pulmonary hypertension animal models and found that the activation of sympathetic nervous system and renin-angiotensin-aldosterone system can be suppressed by the surgical removal of sympathetic nerve around the pulmonary artery. As a result, the pulmonary artery pressure is lowered and the reconstruction of right ventricle is accelerated.

 

This research is introducing a brand new treatment of PAH. In the coming years, we may be able to perform minimally invasive pulmonary artery denervation precisely with the help of thoracoscopic surgery and near-infrared intraoperative imaging of sympathetic nerves. Therefore, we may have more options to offer better clinical intervention and PAH treatment.

 

(Fuwai Hospital)