Safety and Efficacy of Pulmonary Artery Denervation in Patients With Pulmonary Arterial Hypertension (PADN-CFDA)
A Randomised, Single-blind, Sham Operation-controlled Study to Evaluate the Safety and Efficacy of the Pulmonary Artery Denervation for the Treatment of Pulmonary Arterial Hypertension
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Jiangsu
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Nanjing, Jiangsu, China, 210006
- Nanjing First Hospital
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
Provision of informed consent prior to any study specific procedures; Men and women 18 years and older; Group I PAH, defined as a mPAP≥25mmHg, PCWP<15mmHg and PVR[The PVR =(mPAP-PCWP)/CO]>3.0 Woods unit.
Exclusion Criteria:
General exclusion criteria:
Pregnancy and breast feeding mother; Estimated life expectancy < 12 months; Scheduled major surgery in the next 6 months; Inability to follow the protocol and comply with follow-up requirements or any other reason that the investigator feels would place the patient at increased risk; Previous enrolment in this study or treatment with an investigational drug or device under another study protocol in the past 30 days.
Procedural exclusion criteria:
WHO group II, III, IV, V PH Severe Renal dysfunction (Ccr<30 ml/min) Blood platelet count<100,000/L Expected life span<6-month Systematical inflammation Malignant cancer(s) Tricuspid valve stenosis, Supra-pulmonary valve stenosis Allergic to studied drugs or metal materials.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Experimental: PADN + 5-phosphodiesterase
A total of 64 patients are assigned to PADN + 5-phosphodiesterase group after randomization schedule.
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PADN was performed at three sites at the conjunctional area between the distal main trunk and the ostial left branch.
The following ablation parameters were programmed at each point: a temperature of 45 ℃-50 ℃, energy ≤15 W, and a time of 120 seconds.
The procedure would cease for 10 seconds if the patient felt intolerable chest pain during the procedure.
The EKG and pressure lines (including cardiac output) were monitored and continuously recorded throughout the procedure.
Other Names:
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Sham Comparator: Sham operation + 5-phosphodiesterase
A total of 64 patients are assigned to sham operation + 5-phosphodiesterase group after randomization schedule.
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The radiofrequency ablation catheter placed, no ablations for patients in the sham PADN group.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Change From Baseline in 6-Minute Walk Distance (6MWD) at 6 Month
Time Frame: Baseline, 6 Month
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6MWD was the distance that a participant could walk in 6 minutes.
Participants were asked to perform the test at a pace that was comfortable to them, with as many breaks as they needed.
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Baseline, 6 Month
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change From Baseline in Systolic Pulmonary Arterial Pressure (sPAP) at 6 Month
Time Frame: Baseline, 6 Month
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sPAP was measured using a pressure transducer positioned at the mid-axillary line with the participant in the supine position.
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Baseline, 6 Month
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Change From Baseline in Mean Pulmonary Arterial Pressure (mPAP) at 6 Month
Time Frame: Baseline, 6 Month
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mPAP was measured using a pressure transducer positioned at the mid-axillary line with the participant in the supine position.
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Baseline, 6 Month
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Change From Baseline in Cardiac Output (CO) at 6 Month
Time Frame: Baseline, 6 Month
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CO is the volume of blood being pumped by the heart ventricle in the time interval of one minute.
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Baseline, 6 Month
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Change From Baseline in Pulmonary Capillary Wedge Pressure (PCWP) at 6 Month
Time Frame: Baseline, 6 Month
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PCWP was measured by pulmonary artery catheterization and provided an indirect measure of left atrial pressure.
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Baseline, 6 Month
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Change From Baseline in Pulmonary Vascular Resistance (PVR) at 6 Month
Time Frame: Baseline, 6 Month
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PVR: calculated by subtracting PCWP from mPAP and dividing by cardiac output in pulmonary circulation (COpulm).
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Baseline, 6 Month
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Change From Baseline in Right Ventricle Functional at 6 Month
Time Frame: Baseline, 6 Month
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Right ventricle functional measures by echocardiography include right ventricle systolic and diastolic functional variables.
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Baseline, 6 Month
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PAH-related events
Time Frame: 6 Month
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PAH-related events were defined as those caused by worsening of PAH, initiation of treatment with intravenous or subcutaneous prostanoids, lung transplantation, atrial septostomy, or all-cause mortality.
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6 Month
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Study Chair: Hang Zhang, MD, Nanjing First Hospital, Nanjing Medical University
Publications and helpful links
General Publications
- 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 Sep 17;62(12):1092-1100. doi: 10.1016/j.jacc.2013.05.075. Epub 2013 Jul 10.
- 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 Nov;8(11):e002837. doi: 10.1161/CIRCINTERVENTIONS.115.002837.
- Zhang H, Wei Y, Zhang C, Yang Z, Kan J, Gu H, Fan F, Gu H, Wang Q, Xie D, Zhang G, Guo X, Yin Y, Jin B, Zhou H, Yang Z, Wang Z, Xin Y, Zhang C, Meng L, Wang X, Sun J, Zhao C, Zhang J, Yan X, Chen F, Yao C, Stone GW, Chen SL. Pulmonary Artery Denervation for Pulmonary Arterial Hypertension: A Sham-Controlled Randomized PADN-CFDA Trial. JACC Cardiovasc Interv. 2022 Dec 12;15(23):2412-2423. doi: 10.1016/j.jcin.2022.09.013. Epub 2022 Sep 18.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Estimated)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- NFH20170501
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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