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Renal Denervation Reduced Ventricular Arrhythmia After Myocardial Infarction by Inhibiting Sympathetic Activity and Remodeling

BACKGROUND: Ventricular arrhythmia after myocardial infarction is the most important risk factor for sudden cardiac death, which poses a serious threat to human health. As the correlation between autonomic nervous systemic dysfunction and heart rhythm abnormality has been gradually revealed, remedie...

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Autores principales: Zhang, Wen‐hui, Zhou, Qi‐na, Lu, Yan‐mei, Li, Yao‐dong, Zhang, Ling, Zhang, Jiang‐hua, Xing, Qiang, Lv, Wen‐kui, Cheng, Xin‐chun, Zhang, Ge‐ge, Wang, Xue‐sheng, Gu, Qi, Lou, Xue, Guli, Buajier, Tang, Bao‐peng, Zhou, Xian‐hui
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6474949/
https://www.ncbi.nlm.nih.gov/pubmed/30371294
http://dx.doi.org/10.1161/JAHA.118.009938
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author Zhang, Wen‐hui
Zhou, Qi‐na
Lu, Yan‐mei
Li, Yao‐dong
Zhang, Ling
Zhang, Jiang‐hua
Xing, Qiang
Lv, Wen‐kui
Cheng, Xin‐chun
Zhang, Ge‐ge
Wang, Xue‐sheng
Gu, Qi
Lou, Xue
Guli, Buajier
Tang, Bao‐peng
Zhou, Xian‐hui
author_facet Zhang, Wen‐hui
Zhou, Qi‐na
Lu, Yan‐mei
Li, Yao‐dong
Zhang, Ling
Zhang, Jiang‐hua
Xing, Qiang
Lv, Wen‐kui
Cheng, Xin‐chun
Zhang, Ge‐ge
Wang, Xue‐sheng
Gu, Qi
Lou, Xue
Guli, Buajier
Tang, Bao‐peng
Zhou, Xian‐hui
author_sort Zhang, Wen‐hui
collection PubMed
description BACKGROUND: Ventricular arrhythmia after myocardial infarction is the most important risk factor for sudden cardiac death, which poses a serious threat to human health. As the correlation between autonomic nervous systemic dysfunction and heart rhythm abnormality has been gradually revealed, remedies targeting autonomic nervous system dysfunction, especially the sympathetic nerve, have emerged. Among them, renal denervation is noted for its powerful effect on the inhibition of sympathetic nerve activity. We aim to investigate whether renal denervation can reduce ventricular arrhythmia after myocardial infarction and thus decrease the risk of sudden cardiac death. In addition, we explore the potential mechanism with respect to nerve activity and remodeling. METHODS AND RESULTS: Twenty‐four beagles were randomized into the control (n=4), renal denervation (n=10), and sham (n=10) groups. Permanent left anterior descending artery ligation was performed to establish myocardial infarction in the latter 2 groups. Animals in the renal denervation group underwent both surgical and chemical renal denervation. Compared with dogs in the sham group, dogs in the renal denervation group demonstrated attenuated effective refractory period shortening and inhomogeneity, flattened restitution curve, increased ventricular threshold, and decreased ventricular arrhythmia. Heart rate variability assessment, catecholamine measurement, and nerve discharge recordings all indicated that renal denervation could reduce whole‐body and local tissue sympathetic tone. Tissue analysis revealed a significant decrease in neural remodeling in both the heart and stellate ganglion. CONCLUSIONS: Surgical and chemical renal denervation decreased whole‐body and local tissue sympathetic activity and reversed neural remodeling in the heart and stellate ganglion. Consequently, renal denervation led to beneficial remodeling of the electrophysiological characteristics in the infarction border zone, translating to a decrease in ventricular arrhythmia after myocardial infarction.
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spelling pubmed-64749492019-04-24 Renal Denervation Reduced Ventricular Arrhythmia After Myocardial Infarction by Inhibiting Sympathetic Activity and Remodeling Zhang, Wen‐hui Zhou, Qi‐na Lu, Yan‐mei Li, Yao‐dong Zhang, Ling Zhang, Jiang‐hua Xing, Qiang Lv, Wen‐kui Cheng, Xin‐chun Zhang, Ge‐ge Wang, Xue‐sheng Gu, Qi Lou, Xue Guli, Buajier Tang, Bao‐peng Zhou, Xian‐hui J Am Heart Assoc Original Research BACKGROUND: Ventricular arrhythmia after myocardial infarction is the most important risk factor for sudden cardiac death, which poses a serious threat to human health. As the correlation between autonomic nervous systemic dysfunction and heart rhythm abnormality has been gradually revealed, remedies targeting autonomic nervous system dysfunction, especially the sympathetic nerve, have emerged. Among them, renal denervation is noted for its powerful effect on the inhibition of sympathetic nerve activity. We aim to investigate whether renal denervation can reduce ventricular arrhythmia after myocardial infarction and thus decrease the risk of sudden cardiac death. In addition, we explore the potential mechanism with respect to nerve activity and remodeling. METHODS AND RESULTS: Twenty‐four beagles were randomized into the control (n=4), renal denervation (n=10), and sham (n=10) groups. Permanent left anterior descending artery ligation was performed to establish myocardial infarction in the latter 2 groups. Animals in the renal denervation group underwent both surgical and chemical renal denervation. Compared with dogs in the sham group, dogs in the renal denervation group demonstrated attenuated effective refractory period shortening and inhomogeneity, flattened restitution curve, increased ventricular threshold, and decreased ventricular arrhythmia. Heart rate variability assessment, catecholamine measurement, and nerve discharge recordings all indicated that renal denervation could reduce whole‐body and local tissue sympathetic tone. Tissue analysis revealed a significant decrease in neural remodeling in both the heart and stellate ganglion. CONCLUSIONS: Surgical and chemical renal denervation decreased whole‐body and local tissue sympathetic activity and reversed neural remodeling in the heart and stellate ganglion. Consequently, renal denervation led to beneficial remodeling of the electrophysiological characteristics in the infarction border zone, translating to a decrease in ventricular arrhythmia after myocardial infarction. John Wiley and Sons Inc. 2018-10-13 /pmc/articles/PMC6474949/ /pubmed/30371294 http://dx.doi.org/10.1161/JAHA.118.009938 Text en © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Research
Zhang, Wen‐hui
Zhou, Qi‐na
Lu, Yan‐mei
Li, Yao‐dong
Zhang, Ling
Zhang, Jiang‐hua
Xing, Qiang
Lv, Wen‐kui
Cheng, Xin‐chun
Zhang, Ge‐ge
Wang, Xue‐sheng
Gu, Qi
Lou, Xue
Guli, Buajier
Tang, Bao‐peng
Zhou, Xian‐hui
Renal Denervation Reduced Ventricular Arrhythmia After Myocardial Infarction by Inhibiting Sympathetic Activity and Remodeling
title Renal Denervation Reduced Ventricular Arrhythmia After Myocardial Infarction by Inhibiting Sympathetic Activity and Remodeling
title_full Renal Denervation Reduced Ventricular Arrhythmia After Myocardial Infarction by Inhibiting Sympathetic Activity and Remodeling
title_fullStr Renal Denervation Reduced Ventricular Arrhythmia After Myocardial Infarction by Inhibiting Sympathetic Activity and Remodeling
title_full_unstemmed Renal Denervation Reduced Ventricular Arrhythmia After Myocardial Infarction by Inhibiting Sympathetic Activity and Remodeling
title_short Renal Denervation Reduced Ventricular Arrhythmia After Myocardial Infarction by Inhibiting Sympathetic Activity and Remodeling
title_sort renal denervation reduced ventricular arrhythmia after myocardial infarction by inhibiting sympathetic activity and remodeling
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6474949/
https://www.ncbi.nlm.nih.gov/pubmed/30371294
http://dx.doi.org/10.1161/JAHA.118.009938
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