Many heart failure patients have been confused like this: Although they have been taking their medicines on time, why do they get so breathless when they move even a little bit? In fact, there is probably an "invisible killer" hidden behind this - type 2 pulmonary hypertension. According to data from the European Heart Journal in 2016, pulmonary hypertension (type 2 pulmonary hypertension) caused by left heart disease accounts for 65% to 80% of all pulmonary hypertension patients.
For a long time, there has been a lack of clinically approved specific and effective treatments for this type of patients, which is a recognized problem in the cardiovascular field. Now, a Chinese original technology is breaking this deadlock.
Recently, at the 2026 European Society of Cardiology Annual Meeting (ESC2026), Chen Shaoliang, the inventor of pulmonary artery denervation (PADN) and chief physician of Nanjing Hospital Affiliated to Nanjing Medical University, was invited to give a special report to share the research results of PADN in the treatment of heart failure-related pulmonary hypertension. The research was simultaneously published in the New England Journal of Medicine. Han Yaling, academician of the Chinese Academy of Engineering, co-corresponding author of this research paper, and leader of the domestic multi-center study of PADN-HF-PH, said: "This study provides clinicians with a high-level evidence-based basis. It is expected to promote the update of cardiovascular guidelines at home and abroad and bring new safe and effective treatment options to patients with late-stage severe type 2 pulmonary hypertension."
When heart failure meets pulmonary hypertension
Known as "Despairing Cardiovascular Cancer"
Pulmonary hypertension, often called "cancer of the cardiovascular field", is a malignant vascular disease. When heart failure is combined with pulmonary hypertension, it is recognized by domestic pulmonary hypertension expert consensus as a high-risk state with extremely poor prognosis. As pulmonary hypertension caused by left heart disease, it is not only the largest affected population and the highest incidence among the five types of pulmonary hypertension, but also one of the important risk factors for death in patients with cardiovascular disease.
Academician Han Yaling introduced that the left heart is unable to pump blood, and blood accumulates in the pulmonary circulation. Long-term pressure increase will thicken and harden the small blood vessels in the lungs, and the pulmonary vascular resistance will increase irreversibly, which will greatly increase the pumping load of the right ventricle. At this time, the patient's cardiac reserve is basically exhausted, and slight stimulation may induce acute critical events, which is also an important adverse prognostic sign of heart failure clearly marked by authoritative guidelines.
Faced with such a dangerous condition, clinical treatment often falls into the dilemma of "nothing can be done". Academician Han Yaling said frankly, “The biggest difficulty we encounter in treatment at present is that although the standard drug therapy (GDMT) recommended by domestic and foreign heart failure diagnosis and treatment guidelines can improve the overall prognosis of heart failure to a certain extent, it is not suitable for the specific group of patients with pulmonary vascular disease who have heart failure combined with pulmonary hypertension. , there is still a lack of specific, officially approved and effective intervention methods. Traditional targeted drugs for type 1 pulmonary hypertension are not suitable for this type of patients, making treatment difficult, patients’ condition is often difficult to control, they are frequently hospitalized due to worsening of heart failure, their quality of life is poor, and their mortality rate is very high.”
This original technology fills a global gap
Bring new hope to patients
In order to fill the technical gap of long-term lack of effective intervention methods for type 2 pulmonary hypertension, Academician Han Yaling served as the principal investigator and led the team to conduct the PADN-HF-PH clinical study, enrolling a total of 264 patients in 25 clinical centers across the country, aiming to evaluate the safety and effectiveness of pulmonary artery denervation in the treatment of pulmonary hypertension related to left heart failure.
"We hope to scientifically verify through a rigorous randomized controlled design that, on the basis of standard drug treatment, combined with pulmonary artery denervation originally developed by Chinese experts, it can safely and effectively block excessive sympathetic nerve activation from the source and effectively reduce patients' elevated pulmonary artery pressure." Han Ya Academician Ling said that the core goal of the research is to prove that this innovative technology can not only improve patients' short-term hemodynamic indicators, but also alleviate patients' mid- and long-term disease deterioration and reduce repeated hospitalizations, improve their actual prognosis, and thus break this clinical bottleneck in the prevention and treatment of heart failure.
Compare guideline-recommended standard medical treatments
Risk of deterioration reduced by 51%
Han Yaling introduced that as an innovative interventional technology, the clinical application of PADN must be precise and rigorous. Strict inclusion criteria have been set in conjunction with the PADN-HF-PH study. Patients who are most suitable for this treatment must meet the following conditions at the same time: basic drug treatment reaches the standard, cardiac function and activity tolerance are significantly impaired, and abnormal hemodynamic indicators meet the requirements of international guidelines for the diagnosis of pulmonary hypertension. PADN treatment can be considered for heart failure patients with preserved or reduced ejection fraction who meet the above conditions, and patients with valvular heart disease who have received valve replacement but still have pulmonary hypertension.
Han Yaling said that this technology cannot completely replace drugs, but is used together with drug treatment to form a dual therapy of "minimally invasive intervention plus drug treatment". The benefits it brings to patients are significant:
1. Safety: The PADN-HF-PH study shows that the surgical trauma is small and the recovery is quick. Except for a few hematomas at the puncture site, no other surgical complications occurred. The overall safety performance during the follow-up period was ideal.
2. In terms of clinical benefit: The PADN-HF-PH study showed that after adjustment, the incidence of clinical deterioration in the PADN plus GDMT group was 25.7% during the 2-year follow-up, and the risk of clinical deterioration was reduced by 51% (HR 0.49, 95% CI 0.30–0.82; P=0.006). PADN combined with GDMT reduced the patient's annual recurrence rate of clinical deterioration events by 35.5%. At the same time, 12 months after surgery, the 6-minute walking distance of patients in the PADN combined with GDMT group increased by 24.8 meters compared with the control group, indicating that the patients' exercise tolerance and functional status were further improved.
Starting more than 20 years ago, faced with the dilemma of unsatisfactory treatment effects and cost-effectiveness for patients with coronary heart disease in my country, Academician Han Yaling took the lead in conducting a series of studies such as CREATE and BRIGHT. More than 20 years later, she helped China independently develop original devices and technologies published in top international academic journals, bringing tangible benefits to thousands of patients. Academician Han Yaling said: "As a Chinese cardiovascular doctor, I feel very proud. As long as this technology can truly help solve patients' clinical pain points, we must have the determination, patience and confidence to verify it with the highest clinical research standards, and overcome difficulties and obstacles until the problem is solved."
