A Trial to Evaluate the Safety and Efficacy of Pulmonary Artery Denervation for the Treatment of Pulmonary Hypertension Associated With Left Heart Failure

Inclusion Criteria:

1. Age ≥18, ≤75 years old;

2. Diagnosed with chronic heart failure for at least 3 months, and have received theGDMT pharmacological treatment based on the 2023 ESC Guidelines for Heart Failurefor at least 1 month;

3. Clinically stable defined by

4. No intravenous diuretics, inotropes or vasodilators for at least 1 month, and

5. Systolic blood pressure (SBP) ≥ 100 and < 160 mmHg and resting heart rate (HR) ≥50 and <100 bpm (<110 bpm for atrial fibrillation) on the day of the procedure

6. New York Heart Association (NYHA) class II-IVa;

7. 6MWD ≥ 100 m and < 450 m;

8. NT-proBNP > 125 pg/mL (BNP > 35 pg/mL);

9. Hemodynamic indicators (RHC) :

10. Mean pulmonary arterial pressure (mPAP) > 20 mmHg

11. Pulmonary capillary wedge pressure (PCWP) >15 mmHg

12. Understand and be willing to sign informed consent, and be willing to follow thefollow-up plan required by the protocol.

Exclusion Criteria:

1. Any of the following:

2. Hypertrophic cardiomyopathy with left ventricular outflow tract obstruction orsystolic anterior motion; pericardial disease; infiltrative or inflammatorymyocardial disease; valvular stenosis of any of the 4 valves, or severeregurgitation of aortic and pulmonary valves, or active endocarditis; or

3. Symptomatic carotid stenosis, or transient ischemic attack (TIA) or strokewithin 30 days prior to randomization; or

4. Untreated congenital heart disease; or

5. Have received any revascularization, including coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) within 6 months prior torandomization; or anticipated to undergo coronary revascularization (CABG orPCI) within 6 months; or

6. Artificial pacemakers, including single-chamber, dual-chamber and three-chamberpacemakers, have been implanted or are anticipated to be implanted within 6months; or

7. Anticipated to undergo ablation of atrial fibrillation within 6 months; or

8. Anticipated to undergo heart valve surgery (valve replacement, valvuloplasty)within 6 months; or

9. Listing for heart/heart-lung transplantation or anticipated to implant aventricular assist device (VAD)

10. Other types of pulmonary hypertension, including WHO Group1, Group3, Group4, Group5;

11. Received pulmonary arterial hypertension (PAH) targeted drugs within 1 month priorto randomization;

12. Anticipated to undergo any surgery within 6 months;

13. The cardiac index (CI) of RHC < 1.5L/min/m²;

14. Severe renal insufficiency (eGFR <30mL/min/1.73m² by MDRD formula);

15. Severe liver insufficiency (Child-Pugh classification C);

16. Platelet count < 50 × 10^9/L;

17. Life expectancy <1 year;

18. Systemic inflammation or other disease requiring long-term use of glucocorticoids orimmunosuppressants;

19. Active infection requiring oral or intravenous antibiotics;

20. Body mass index (BMI) >40 kg/m²;

21. Pregnant or lactating women, or plan to pregnant in one year;

22. Participated in other clinical trials within 3 months prior to signing the informedconsent;

23. Any other circumstances that investigators deem inappropriate to participate in thistrial.