{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T02:25:37Z","timestamp":1790735137089,"version":"4.1.0"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"vor","delay-in-days":510,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T00:00:00Z","timestamp":1716422400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>A recent guideline presented by the ESC Congress in 2022 had indicated a novel therapy targeted at pulmonary artery hypertension, known as pulmonary artery denervation (PADN), which get inspired from a laboratorial trial that could lowering the pulmonary artery pressure through the intervention on the animals. Our aim is to conduct a network meta-analysis to compare the efficacy and safety of PADN from six aspects with the current conventional therapies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>According to the PRISMA guidance, databases including Ovid, ClinicalTrials.gov, Medline, Embase, and PubMed were searched from inception to 22 August 2023, along with a full assessment of the previous five meta-analyses. Data were extracted and curated for Bayesian network meta-analysis. The primary outcome was the change in the 6-min walking distance (6MWD) from baseline with a secondary outcome called change in mean pulmonary artery pressure (mPAP) from baseline. The four safety outcomes included risk of clinical worsening, hospitalization, mortality and severe adverse events (SAEs). The comparison is structured on a contrast model based on 65 randomized controlled trials (RCTs) on PADN and the other conventional mainstream drugs. PADN had a better effect in improving 6MWD than Placebo (\u221277.76 m, 95% CI: \u2212102.04 to \u221254.34 m), Macitentan (\u221265.32 m, 95% CI: \u221295.34 to \u221236.1 m), Bosentan (\u221264.5 m, 95% CI: \u221294.7 to \u221235.07 m), Iloprost (\u221262.66 m, 95% CI: \u221299.48 to \u221227.13 m), Oxygen (\u221262.42 m, 95% CI: \u2212100.01 to \u221225.78 m), Treprostinil (\u221262.01 m, 95% CI: \u221289.04 to \u221235.61 m), Riociguat (\u221260.59 m, 95% CI: \u221286.11 to \u221235.98 m), Selexipag (\u221247.2 m, 95% CI: \u221285.61 to \u221210.19 m), Sildenafil (\u221244.92 m, 95% CI: \u221274.43 to \u221216.15 m), or Sitaxsentan (\u221239.53 m, 95% CI: \u221278.99 to \u22120.76 m). PADN had a better antihypertensive effect than placebo and showed statistical significant lower risks to induce clinical worsening and re-hospitalization than treprostinil, riociguat, and placebo groups. No statistically significant difference in risk of mortality and severe adverse events was observed between PADN versus the other interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Compared with 16 types of conventional therapies and Placebo, PADN has advantage over nine single therapies and Placebo in improving 6MWD and appears to be better than two types of dual-drug combined therapies while with no statistical significance. PADN shows a favourable antihypertensive effect on mPAP and has a lower risk to trigger clinical worsening or hospitalization, while its risk on mortality and severe adverse events is still inconclusive.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.14842","type":"journal-article","created":{"date-parts":[[2024,5,24]],"date-time":"2024-05-24T02:13:56Z","timestamp":1716516836000},"page":"2889-2900","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Pulmonary Artery Denervation Versus Conventional Therapies for PAH: A Systematic Review and Updated Network Meta-Analysis"],"prefix":"10.1093","volume":"11","author":[{"given":"Xiaoyu","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Biostatistics, School of Public Health, Center of Global Health, Nanjing Medical University , Nanjing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, School of Public Health, Center of Global Health, Nanjing Medical University , Nanjing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Longyao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, School of Public Health, Center of Global Health, Nanjing Medical University , Nanjing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoucheng","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, School of Public Health, Center of Global Health, Nanjing Medical University , Nanjing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, School of Public Health, Center of Global Health, Nanjing Medical University , Nanjing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shao-liang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Nanjing First Hospital, The Affiliated Nanjing Hospital of Nanjing Medical University, Nanjing Medical University , Nanjing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Kan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Nanjing First Hospital, The Affiliated Nanjing Hospital of Nanjing Medical University, Nanjing Medical University , Nanjing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongyue","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, School of Public Health, Center of Global Health, Nanjing Medical University , Nanjing ,","place":["China"]},{"name":"Center for Public Health and Epidemic Preparedness & Response, Peking University, Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education , Beijing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,5,23]]},"reference":[{"key":"2026012113151341000_ehf214842-bib-0001","doi-asserted-by":"publisher","first-page":"1379","DOI":"10.1001\/jama.2022.4402","article-title":"Diagnosis and treatment of pulmonary arterial hypertension: a review","volume":"327","author":"Ruopp","year":"2022","journal-title":"JAMA"},{"key":"2026012113151341000_ehf214842-bib-0002","doi-asserted-by":"publisher","first-page":"2361","DOI":"10.1056\/NEJMra2000348","article-title":"Pulmonary arterial hypertension","volume":"385","author":"Hassoun","year":"2021","journal-title":"N Engl J Med"},{"key":"2026012113151341000_ehf214842-bib-0003","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1007\/s00408-020-00375-w","article-title":"Guidelines for the treatment of pulmonary arterial hypertension","volume":"198","author":"Vazquez","year":"2020","journal-title":"Lung"},{"key":"2026012113151341000_ehf214842-bib-0004","doi-asserted-by":"publisher","first-page":"979","DOI":"10.1161\/ATVBAHA.119.312591","article-title":"Transthoracic pulmonary artery denervation","volume":"39","author":"Ogo","year":"2019","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"2026012113151341000_ehf214842-bib-0005","doi-asserted-by":"publisher","first-page":"684","DOI":"10.4244\/EIJ-D-23-00349","article-title":"A sham-controlled randomised trial of pulmonary artery denervation for Group 1 pulmonary arterial hypertension: one-year outcomes of the PADN-CFDA trial","volume":"19","author":"Kan","year":"2023","journal-title":"Euro Intervention"},{"key":"2026012113151341000_ehf214842-bib-0006","doi-asserted-by":"publisher","first-page":"3618","DOI":"10.1093\/eurheartj\/ehac237","article-title":"ESC\/ERS guidelines for the diagnosis and treatment of pulmonary hypertension","volume":"2022","author":"Humbert","year":"2022","journal-title":"Eur Heart J"},{"key":"2026012113151341000_ehf214842-bib-0007","doi-asserted-by":"publisher","first-page":"381","DOI":"10.5603\/CJ.a2020.0186","article-title":"The progress of pulmonary artery denervation","volume":"29","author":"Xie","year":"2022","journal-title":"Cardiol J"},{"key":"2026012113151341000_ehf214842-bib-0008","doi-asserted-by":"publisher","first-page":"1092","DOI":"10.1016\/j.jacc.2013.05.075","article-title":"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)","volume":"62","author":"Chen","year":"2013","journal-title":"J Am Coll Cardiol"},{"key":"2026012113151341000_ehf214842-bib-0009","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1016\/j.jcin.2018.09.021","article-title":"Pulmonary artery denervation significantly increases 6-min walk distance for patients with combined pre- and post-capillary pulmonary hypertension associated with left heart failure: the PADN-5 study","volume":"12","author":"Zhang","year":"2019","journal-title":"JACC Cardiovasc Interv"},{"key":"2026012113151341000_ehf214842-bib-0010","doi-asserted-by":"publisher","first-page":"916","DOI":"10.1016\/j.jacc.2020.06.064","article-title":"Pulmonary artery denervation for patients with residual pulmonary hypertension after pulmonary endarterectomy","volume":"76","author":"Romanov","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"2026012113151341000_ehf214842-bib-0011","doi-asserted-by":"publisher","first-page":"2412","DOI":"10.1016\/j.jcin.2022.09.013","article-title":"Pulmonary artery denervation for pulmonary arterial hypertension: a sham-controlled randomized trial","volume":"15","author":"Zhang","year":"2022","journal-title":"JACC Cardiovasc Interv"},{"key":"2026012113151341000_ehf214842-bib-0012","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1016\/j.hrtlng.2022.01.020","article-title":"A meta-analysis of the efficacy of pulmonary artery denervation in the treatment of pulmonary hypertension","volume":"53","author":"Zheng","year":"2022","journal-title":"Heart Lung"},{"key":"2026012113151341000_ehf214842-bib-0013","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0036-2022","article-title":"Medications for the treatment of pulmonary arterial hypertension: a systematic review and network meta-analysis","volume":"31","author":"Pitre","year":"2022","journal-title":"Eur Respir Rev"},{"key":"2026012113151341000_ehf214842-bib-0014","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1080\/07853890.2020.1746826","article-title":"Comparison of inhaled nitric oxide with aerosolized prostacyclin or analogues for the postoperative management of pulmonary hypertension: a systematic review and meta-analysis","volume":"52","author":"Chen","year":"2020","journal-title":"Ann Med"},{"key":"2026012113151341000_ehf214842-bib-0015","doi-asserted-by":"publisher","first-page":"1007","DOI":"10.1080\/10717544.2021.1927243","article-title":"Efficacy and safety of novel-targeted drugs in the treatment of pulmonary arterial hypertension: a Bayesian network meta-analysis","volume":"28","author":"Fu","year":"2021","journal-title":"Drug Deliv"},{"key":"2026012113151341000_ehf214842-bib-0016","doi-asserted-by":"publisher","first-page":"11117","DOI":"10.21037\/apm-21-2656","article-title":"Riociguat therapy for pulmonary hypertension: a systematic review and meta-analysis","volume":"10","author":"Wang","year":"2021","journal-title":"Ann Palliat Med"},{"key":"2026012113151341000_ehf214842-bib-0017","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1186\/s13643-017-0473-z","article-title":"Approaches to interpreting and choosing the best treatments in network meta-analyses","volume":"6","author":"Mbuagbaw","year":"2017","journal-title":"Syst Rev"},{"key":"2026012113151341000_ehf214842-bib-0018","doi-asserted-by":"publisher","first-page":"5197","DOI":"10.1002\/sim.8360","article-title":"A comparison of arm-based and contrast-based models for network meta-analysis","volume":"38","author":"White","year":"2019","journal-title":"Stat Med"},{"key":"2026012113151341000_ehf214842-bib-0019","doi-asserted-by":"publisher","first-page":"777","DOI":"10.7326\/m14-2385","article-title":"The PRISMA extension statement for reporting of systematic reviews incorporating network meta-analyses of health care interventions: checklist and explanations","volume":"162","author":"Hutton","year":"2015","journal-title":"Ann Intern Med"},{"key":"2026012113151341000_ehf214842-bib-0020","doi-asserted-by":"publisher","first-page":"502","DOI":"10.1161\/CIRCULATIONAHA.113.001458","article-title":"Riociguat for patients with pulmonary hypertension caused by systolic left ventricular dysfunction: a phase IIb double-blind, randomized, placebo-controlled, dose-ranging hemodynamic study","volume":"128","author":"Bonderman","year":"2013","journal-title":"Circulation"},{"key":"2026012113151341000_ehf214842-bib-0021","doi-asserted-by":"publisher","first-page":"1274","DOI":"10.1378\/chest.14-0106","article-title":"Acute hemodynamic effects of riociguat in patients with pulmonary hypertension associated with diastolic heart failure (DILATE-1): a randomized, double-blind, placebo-controlled, single-dose study","volume":"146","author":"Bonderman","year":"2014","journal-title":"Chest"},{"key":"2026012113151341000_ehf214842-bib-0022","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1016\/j.chest.2016.08.1461","article-title":"Comparative effectiveness of pharmacologic interventions for pulmonary arterial hypertension: a systematic review and network meta-analysis","volume":"151","author":"Jain","year":"2017","journal-title":"Chest"},{"key":"2026012113151341000_ehf214842-bib-0023","doi-asserted-by":"publisher","first-page":"58","DOI":"10.4244\/aij-d-21-00033","article-title":"Long-term mortality after pulmonary artery denervation stratified by baseline functional class in patients with pulmonary arterial hypertension: long-term mortality after PADN stratified by functional class","volume":"8","author":"Zhang","year":"2022","journal-title":"Asia Intervention"},{"key":"2026012113151341000_ehf214842-bib-0024","doi-asserted-by":"publisher","first-page":"691","DOI":"10.1183\/09031936.06.00057906","article-title":"Combining inhaled iloprost with bosentan in patients with idiopathic pulmonary arterial hypertension","volume":"28","author":"Hoeper","year":"2006","journal-title":"Eur Respir J"},{"key":"2026012113151341000_ehf214842-bib-0025","doi-asserted-by":"publisher","first-page":"489","DOI":"10.4187\/respcare.05280","article-title":"Treatment of pulmonary arterial hypertension using initial combination therapy of bosentan and iloprost","volume":"62","author":"Han","year":"2017","journal-title":"Respir Care"},{"key":"2026012113151341000_ehf214842-bib-0026","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1016\/j.healun.2009.09.005","article-title":"Exercise improvement and plasma biomarker changes with intravenous treprostinil therapy for pulmonary arterial hypertension: a placebo-controlled trial","volume":"29","author":"Hiremath","year":"2010","journal-title":"J Heart Lung Transplant"},{"key":"2026012113151341000_ehf214842-bib-0027","doi-asserted-by":"publisher","first-page":"2424","DOI":"10.1016\/j.jcin.2022.10.004","article-title":"Pulmonary artery denervation: a new therapeutic for pulmonary arterial hypertension?","volume":"15","author":"Leopold","year":"2022","journal-title":"JACC Cardiovasc Interv"},{"key":"2026012113151341000_ehf214842-bib-0028","doi-asserted-by":"publisher","first-page":"1124","DOI":"10.1093\/eurheartj\/ehq011","article-title":"Combination therapy with bosentan and sildenafil in Eisenmenger syndrome: a randomized, placebo-controlled, double-blinded trial","volume":"31","author":"Iversen","year":"2010","journal-title":"Eur Heart J"}],"container-title":["ESC Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/11\/5\/2889\/64516185\/eschf_11_5_2889.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/11\/5\/2889\/64516185\/eschf_11_5_2889.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T18:17:13Z","timestamp":1769019433000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eschf\/article\/11\/5\/2889\/8271289"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,23]]},"references-count":28,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,5,23]]},"published-print":{"date-parts":[[2024,10,1]]}},"URL":"https:\/\/doi.org\/10.1002\/ehf2.14842","relation":{},"ISSN":["2055-5822"],"issn-type":[{"value":"2055-5822","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,10]]},"published":{"date-parts":[[2024,5,23]]},"assertion":[{"value":"2023-05-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}