Renal Sympathetic Denervation Improves Outcomes in a Canine Myocardial Infarction Model

Abstract

Background Myocardial infarction (MI) is the main cause of heart failure (HF), and sympathetic nerve activity is associated with prognosis chronic heart failure. Renal sympathetic denervation (RDN) is noted for its powerful effect on the inhibition of sympathetic nerve activity. This study investigated the effect of RDN on heart failure in dogs after myocardial infarction. Material/Methods The experimental animals were randomized into 2 groups: the MI group (n=12) and the sham operation group (n=6). In the MI group we established an MI model by permanently ligating the left anterior descending branch. After 4 weeks, the MI dogs were randomly divided into 2 groups: the MI+RDN group (MI+renal sympathetic denervation, n=6) and the simple MI group (n=6). Animals in the MI+RDN group underwent both surgical and chemical renal denervation. Results Compared with sham operation group, left ventricular fraction shortening (LVFS) and left ventricular ejection fraction (LVEF) were significantly reduced in the simple MI group, while the reduction was partly reversed in the MI+RDN group. RDN reduced sympathetic nerve activity and release of B-type natriuretic peptide (BNP) and Angiotensin II (AngII) in the MI+ RDN group but not in the simple MI group. Conclusions Canine renal sympathetic denervation prevents myocardial malignant remodeling by lowering the activity of the systemic sympathetic nerve and inhibiting renin-angiotensin-aldosterone system (RASS) activation, providing a new target and method for the treatment of heart failure.

Renal Sympathetic Denervation Attenuates Congestive Heart Failure in Angiotensin II-Dependent Hypertension: Studies with Ren-2 Transgenic Hypertensive Rats with Aortocaval Fistula

“…It is unlikely for this divergence to be a consequence of methodological inaccuracy in the preparation of tissue samples for the NE assay. The employed method of tissue preparation (i.e., isolation and removal of the adrenal glands and immediate homogenization in precooled methanol) was validated repeatedly and is employed not only by our group but also by many other groups studying the role of RSNA in various physiological and pathophysiological states [15-22, 41]. On the other hand, our present findings show that employed RDN procedure was fully effective, because kidney NE concentration was reduced by >90%, indicating virtual abolishment of RSNA.…”

“…While renal denervation (RDN) (ablation of both afferent and efferent renal nerves) was originally introduced for the treatment of resistant hypertension [16], recent studies indicate that it may be a promising tool for the treatment of CHF [17,18]. However, despite vast knowledge regarding the important role of SNS in the regulation of kidney function [19], the effects of RDN on kidney function in CHF have been disregarded and all studies were focused on the changes in cardiac function so far [17,18,[20][21][22]]. Another important limitation of those studies is that a possible beneficial effect of RDN on long-term survival in CHF has not been explored.…”

Effects of renal denervation on cardiac function after percutaneous coronary intervention in patients with acute myocardial infarction

“…The mechanism is not fully clear at present, RDN may induce the increase of the γ-aminobutyric acid (GABA) activity in the hypothalamic paraventricular nucleus, leading to the inhibition of the sympathetic nervous system [ 16 ]. At the same time, GABA can inhibit the RAAS system and reduce the level of Ang II in peripheral blood [ 17 , 18 ], which is beneficial in cardiovascular diseases. At present, RDN is widely used in diseases such as hypertension and heart failure [ 10 , 19 ].…”