Pulmonary artery denervation: a novel treatment modality for pulmonary hypertension

Pulmonary arterial hypertension (PAH) is a complex pulmonary vascular disease that leads to right ventricular (RV) failure and sudden cardiac death (1). PAH is associated with sympathetic nervous system (SNS) over-stimulation, renin-angiotensin-aldosterone system (RAAS) activation and cardiac arrhythmias. RAAS activation generates vasoactive compounds that result in pulmonary vasoconstriction and vascular remodeling, hallmarks of PAH (2). It is suggested that patients with PAH often have a low cardiac output and that RAAS and SNS over-activation are merely compensatory mechanisms for that decreased cardiac output (3).