Study for Evaluation of Safety and Efficacy of PADN to Treat Combined Post- and Pre- Capillary Pulmonary Hypertension Associated With Chronic Heart Failure（PADN-CpcPH-PILOT）

Inclusion Criteria:

1. Age ≥18, ≤85 years;

2. PH must be confirmed by RHC, defined as:

3. Mean pulmonary arterial pressure (mPAP) >20mmHg, and;

4. Pulmonary capillary wedge pressure (PCWP) >15mmHg, and；

5. Pulmonary vascular resistance (PVR) > 2WU.

6. Chronic heart failure has been diagnosed at least 3 months before screening and havebeen treated on the GDMT according to 2022 AHA/ACC Guidelines for Heart Failure forat least 1 month;

7. Clinically stable HF for at least 1 month, defined as:

8. No need of intravenous diuretics, inotropes or vasodilators, and

9. Systolic blood pressure (SBP) ≥ 100 and < 160 mmHg, and

10. Resting heart rate (HR) ≥ 50 bpm and <100 bpm (>110 bpm in presence of atrialfibrillation) on the day of the procedure.

11. NYHA class II-IVa;

12. 6MWD ≥ 100 m and ≤ 450 m;

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

14. Understand and be willing to sign informed consent and be strictly willing to followthe protocol.

Exclusion Criteria:

1. Any of the following:

2. Hypertrophic cardiomyopathy with left ventricular (LV) outflow tractobstruction and/or mitral valvular systolic anterior motion (SAM); or

3. Pericardial disease; or

4. Infiltrative or inflammatory myocardial disease; or

5. Valvular heart disease with stenosis or with severe regurgitation; or

6. Active endocarditis; or

7. Symptomatic carotid stenosis, or TIA or stroke within 30 days prior torandomization; or

8. Congenital heart disease; or

9. Having received any revascularization, including coronary artery bypassgrafting (CABG) or percutaneous coronary intervention (PCI) within 6 monthsprior to randomization; or anticipated to undergo coronary revascularization (CABG or PCI) within 6 months; or

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

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

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

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

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

15. Anticipated to undergo any surgery within the next 6 months;

16. Cardiac index (CI) measured by RHC < 1.5L/min/m2;

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

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

19. Platelet count < 50 × 109/L;

20. Life expectancy < 1 year;

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

22. Active infection requiring oral or intravenous antibiotics;

23. Cannot tolerate warfarin, aspirin, clopidogrel, and any of GDMT medicines;

24. Body mass index (BMI) > 40 kg/m²;

25. Pregnant or lactating women, or planning to be pregnant within one year;

26. Participation in other clinical trials within 3 months prior to signing the informedconsent;

27. Any other circumstances that investigators deemed inappropriate to participate inthis trial.