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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”

2016; Lippincott Williams & Wilkins; Volume: 9; Issue: 1 Linguagem: Inglês

10.1161/circinterventions.115.003422

1941-7632

Marius M. Hoeper, Nazzareno Galiè,

Heart Failure Treatment and Management

HomeCirculation: Cardiovascular InterventionsVol. 9, No. 1Letter 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" Free AccessLetterPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessLetterPDF/EPUBLetter 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" Marius M. Hoeper, MD Nazzareno Galiè, MD Marius M. HoeperMarius M. Hoeper Department of Respiratory Medicine Hannover Medical School and German Center of Lung Research (DZL) Hannover, Germany Nazzareno GalièNazzareno Galiè Department of Experimental Diagnostic and Specialty Medicine (DIMES) University of Bologna Bologna, Italy Originally published11 Jan 2016https://doi.org/10.1161/CIRCINTERVENTIONS.115.003422Circulation: Cardiovascular Interventions. 2016;9To the Editor:We read with interest the article by Chen et al,1 which addressed an interesting new therapeutic strategy for patients with pulmonary hypertension, but at the same time, raised several issues on the conduct of this study. Most importantly, we have serious concerns about the withdrawal of targeted therapies for investigative reasons, and we question whether this approach was ethical, as these therapies improve symptoms and outcomes, at least in patients with pulmonary arterial hypertension.2,3 In addition, we take issue with the authors claiming that their procedure improved survival. There was no control group, and the reported 12% all-cause mortality after 1 year was higher than in most contemporary series.4,5 Although unproven, it is possible that some of these deaths might have been related to the withdrawal of effective therapies.The article contains additional flaws, including an incorrect classification of pulmonary hypertension (World Health Organization group II pulmonary arterial hypertension does not exist),3 and baseline medications that do not meet current standards of care (in particular, the use of prostacyclin analogues in 89% of patients with pulmonary hypertension caused by left heart disease).Novel therapeutic concepts for pulmonary hypertension are always embraced, and pulmonary artery denervation might be a promising new strategy that deserves careful investigation. Ideally, randomized, controlled, multicenter studies involving centers specialized in the care of patients with pulmonary hypertension should follow next.Marius M. Hoeper, MDDepartment of Respiratory Medicine Hannover Medical School and German Center of Lung Research (DZL), Hannover, GermanyNazzareno Galiè, MDDepartment of Experimental Diagnostic and Specialty Medicine (DIMES) University of Bologna Bologna, ItalyDisclosuresDr Hoeper has received fees for lectures and consultations from Actelion, Bayer, Gilead, GSK, and Pfizer. Dr Galiè has received grant support and personal fees from GlaxoSmithKline, Actelion, Bayer, and Pfizer.References1. Chen SL, Zhang H, Xie DJ, Zhang J, Zhou L, Rothman AMK, 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 Scholar2. Galiè N, Manes A, Negro L, Palazzini M, Bacchi-Reggiani ML, Branzi A. A meta-analysis of randomized controlled trials in pulmonary arterial hypertension.Eur Heart J. 2009; 30:394–403. doi: 10.1093/eurheartj/ehp022.CrossrefMedlineGoogle Scholar3. Galiè N, Humbert M, Vachiery JL, Gibbs S, Lang I, Torbicki A, Simonneau G, Peacock A, Vonk Noordegraaf A, Beghetti M, Ghofrani A, Gomez Sanchez MA, Hansmann G, Klepetko W, Lancellotti P, Matucci M, McDonagh T, Pierard LA, Trindade PT, Zompatori M, Hoeper M. 2015 ESC/ERS guidelines for the diagnosis and treatment of pulmonary hypertension: the Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT).Eur Respir J. 2015; 46:903–975. doi: 10.1183/13993003.01032-2015.CrossrefMedlineGoogle Scholar4. Hoeper MM, Huscher D, Ghofrani HA, Delcroix M, Distler O, Schweiger C, Grunig E, Staehler G, Rosenkranz S, Halank M, Held M, Grohé C, Lange TJ, Behr J, Klose H, Wilkens H, Filusch A, Germann M, Ewert R, Seyfarth HJ, Olsson KM, Opitz CF, Gaine SP, Vizza CD, Vonk-Noordegraaf A, Kaemmerer H, Gibbs JS, Pittrow D. Elderly patients diagnosed with idiopathic pulmonary arterial hypertension: results from the COMPERA registry.Int J Cardiol. 2013; 168:871–880. doi: 10.1016/j.ijcard.2012.10.026.CrossrefMedlineGoogle Scholar5. Dardi F, Manes A, Palazzini M, Bachetti C, Mazzanti G, Rinaldi A, Albini A, Gotti E, Monti E, Bacchi Reggiani ML, Galiè N. Combining bosentan and sildenafil in pulmonary arterial hypertension patients failing monotherapy: real-world insights.Eur Respir J. 2015; 46:414–421. doi: 10.1183/09031936.00209914.CrossrefMedlineGoogle Scholar Previous Back to top Next FiguresReferencesRelatedDetailsCited By Stącel T, Latos M, Urlik M, Nęcki M, Antończyk R, Hrapkowicz T, Kurzyna M and Ochman M (2021) Interventional and Surgical Treatments for Pulmonary Arterial Hypertension, Journal of Clinical Medicine, 10.3390/jcm10153326, 10:15, (3326) García-Lunar I, Pereda D, Ibanez B and García-Álvarez A (2020) Neurohormonal Modulation as a Therapeutic Target in Pulmonary Hypertension, Cells, 10.3390/cells9112521, 9:11, (2521) Ferreira A, Serejo J, Durans R, Pereira Costa J, Maciel A, Vieira A, Dias-Filho C, Dias C, Bomfim M, Mostarda C and Brito-Monzani J Dose-related Effects of Resveratrol in Different Models of Pulmonary Arterial Hypertension: A Systematic Review, Current Cardiology Reviews, 10.2174/1573403X15666191203110554, 16:3, (231-240) Hoeper M (2020) Pulmonary Artery Denervation, Journal of the American College of Cardiology, 10.1016/j.jacc.2020.06.067, 76:8, (927-929), Online publication date: 1-Aug-2020. Feshchenko D, Rudenko B, Shanoyan A, Drapkina O, Kontsevaya A, Gavrilova N, Shukurov F and Vasiliev D (2019) Pulmonary artery denervation in patients with pulmonary hypertension: present state and clinical experience, Russian Journal of Cardiology, 10.15829/1560-4071-2019-12-162-168:12, (162-168) Feshchenko D, Rudenko B, Shanoyan A, Drapkina O, Kontsevaya A, Gavrilova N, Shukurov F and Vasiliev D (2019) Pulmonary artery denervation in patients with pulmonary hypertension: present state and clinical experience, Russian Journal of Cardiology, 10.15829/1560-4071-2019-12-:12, (162-168) Garcia-Lunar I, Pereda D, Santiago E, Solanes N, Nuche J, Ascaso M, Bobí J, Sierra F, Dantas A, Galán C, San Antonio R, Sánchez-Quintana D, Sánchez-González J, Barberá J, Rigol M, Fuster V, Ibáñez B, Sabaté M and García-Álvarez A (2019) Effect of pulmonary artery denervation in postcapillary pulmonary hypertension: results of a randomized controlled translational study, Basic Research in Cardiology, 10.1007/s00395-018-0714-x, 114:2, Online publication date: 1-Mar-2019. Ntokou A and Greif D (2018) Vagal Nerve Stimulation for Pulmonary Hypertension, JACC: Basic to Translational Science, 10.1016/j.jacbts.2018.09.002, 3:5, (672-674), Online publication date: 1-Oct-2018. Sandoval J (2018) Terapias intervencionistas en hipertensión pulmonar, Revista Española de Cardiología, 10.1016/j.recesp.2018.01.020, 71:7, (565-574), Online publication date: 1-Jul-2018. Sandoval J (2018) Interventional Therapies in Pulmonary Hypertension, Revista Española de Cardiología (English Edition), 10.1016/j.rec.2018.02.002, 71:7, (565-574), Online publication date: 1-Jul-2018. Gorter T, van Veldhuisen D, Bauersachs J, Borlaug B, Celutkiene J, Coats A, Crespo-Leiro M, Guazzi M, Harjola V, Heymans S, Hill L, Lainscak M, Lam C, Lund L, Lyon A, Mebazaa A, Mueller C, Paulus W, Pieske B, Piepoli M, Ruschitzka F, Rutten F, Seferovic P, Solomon S, Shah S, Triposkiadis F, Wachter R, Tschöpe C and de Boer R (2017) Right heart dysfunction and failure in heart failure with preserved ejection fraction: mechanisms and management. Position statement on behalf of the Heart Failure Association of the European Society of Cardiology, European Journal of Heart Failure, 10.1002/ejhf.1029, 20:1, (16-37), Online publication date: 1-Jan-2018. Perros F, de Man F, Bogaard H, Antigny F, Simonneau G, Bonnet S, Provencher S, Galiè N and Humbert M (2017) Use of β-Blockers in Pulmonary Hypertension, Circulation: Heart Failure, 10:4, Online publication date: 1-Apr-2017. Simonneau G, Hoeper M, McLaughlin V, Rubin L and Galiè N (2016) Future perspectives in pulmonary arterial hypertension, European Respiratory Review, 10.1183/16000617.0084-2016, 25:142, (381-389), Online publication date: 1-Dec-2016. Chen S, Zhang H, Xie D, Zhang J, Zhou L, Rothman A and Stone G (2016) 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", Circulation: Cardiovascular Interventions, 9:1, (e003463), Online publication date: 1-Jan-2016. January 2016Vol 9, Issue 1 Advertisement Article InformationMetrics © 2016 American Heart Association, Inc.https://doi.org/10.1161/CIRCINTERVENTIONS.115.003422PMID: 26755573 Originally publishedJanuary 11, 2016 PDF download Advertisement SubjectsPulmonary Hypertension