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Renal sympathetic denervation inhibits the development of left ventricular mechanical dyssynchrony during the progression of heart failure in dogs.

Hu W, Zhao QY, Yu SB, Sun B, Chen L, Cao S, Guo RQ - Cardiovasc Ultrasound (2014)

Bottom Line: The LV interstitial fibrosis was determined by histological analysis.The levels of LV dyssynchrony were lower in the RSD group than in the control group (p<0.001 for longitudinal, circumferential and radial dyssynchrony, respectively).The levels of plasma Ang II, aldosterone and NE were lower in the RSD group than in the control group.

View Article: PubMed Central - PubMed

Affiliation: Department of Ultrasound, Renmin Hospital of Wuhan University, Jiefang Road 238#, Wuchang District, Wuhan 430060, China. gzrdoct@163.com.

ABSTRACT

Background: The purpose of this study was to investigate whether transcatheter renal sympathetic denervation (RSD) interfere with the development of left ventricular (LV) mechanical dyssynchrony during the progression of heart failure (HF).

Methods: Nineteen beagles were randomly divided into sham-operated group (six dogs), control group (seven dogs), and RSD group (six dogs). Sham-operated group were implanted with pacemakers without pacing; Control group were implanted with pacemakers and underwent 3 weeks of rapid right ventricular pacing; and RSD group underwent catheter-based RSD bilaterally and were simultaneously implanted with pacemakers. Both LV strain and LV dyssynchrony were analyzed via 2D speckle-tracking strain echocardiography to evaluate LV function. Longitudinal dyssynchrony was determined as the standard deviation for time-to-peak speckle-tracking strain on apical 4- and 2-chamber views. Radial and circumferential dyssynchrony was determined as the standard deviation for time-to-peak speckle-tracking strain in mid- and base-LV short-axis views. Each myocardial function was also evaluated by averaging the peak systolic strains. LV systolic pressure (LVSP) and LV end-diastolic pressure (LVEDP) were measured. The LV interstitial fibrosis was determined by histological analysis. Plasma angiotensin II (Ang II), aldosterone and norepinephrine (NE) levels were also measured.

Results: After 3 weeks, all of the dogs in both the control and RSD groups showed greater LV end-diastolic volume compared with the sham-operated group; however, the dogs in the RSD group had a higher LV ejection fraction (LVEF) than the dogs in the control group (p<0.001). The LV systolic strains were higher in the RSD group than in the control group (p<0.001 for longitudinal, circumferential and radial strain, respectively). The levels of LV dyssynchrony were lower in the RSD group than in the control group (p<0.001 for longitudinal, circumferential and radial dyssynchrony, respectively). Compared with dogs with control alone, RSD dogs had lower LV end-diastolic pressures and less fibrous tissue. The levels of plasma Ang II, aldosterone and NE were lower in the RSD group than in the control group.

Conclusions: RSD inhibites the development of left ventricular mechanical dyssynchrony during the progression of heart failure in dogs.

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Related in: MedlinePlus

LV dyssynchrony in three directions (radial, circumferential and longitudinal) in the sham-operated group (sham), the pacing-induced heart failure group (control), and the group treated with renal sympathetic denervation and rapid ventricular pacing (RSD). LV mechanical dyssynchrony was assessed using the standard deviation of the time from onset of the QRS interval to peak strain.
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Fig1: LV dyssynchrony in three directions (radial, circumferential and longitudinal) in the sham-operated group (sham), the pacing-induced heart failure group (control), and the group treated with renal sympathetic denervation and rapid ventricular pacing (RSD). LV mechanical dyssynchrony was assessed using the standard deviation of the time from onset of the QRS interval to peak strain.

Mentions: Left ventricular strain and dyssynchrony were analyzed via two-dimensional speckle tracking echocardiography, using an ECHOPAC workstation as previously described [29]. Routine two-dimensional images were obtained via mid- and base-LV short-axis views and apical four- and two-chamber views at rates of 40–60 frames/s. The speckles of interest were followed throughout the entire cardiac cycle, and myocardial longitudinal, radial and circumferential deformation was each calculated automatically. Longitudinal strain of the LV (LVLS) was calculated as the average peak longitudinal strain across 12 segments of apical four- and two-chamber views. LV circumferential strain (LVCS) and LV radial strain (LVRS) were obtained from 12 segments of mid- and base-LV short-axis views. Mechanical dyssynchrony was assessed using the standard deviations of the time from onset of the QRS interval to the peak longitudinal strain of the LV (LV-Tls-12SD), the peak radial strain of the LV (LV-Trs-12SD) and the peak circumferential strain of the LV (LV-Tcs-12SD) (Figure 1).Figure 1


Renal sympathetic denervation inhibits the development of left ventricular mechanical dyssynchrony during the progression of heart failure in dogs.

Hu W, Zhao QY, Yu SB, Sun B, Chen L, Cao S, Guo RQ - Cardiovasc Ultrasound (2014)

LV dyssynchrony in three directions (radial, circumferential and longitudinal) in the sham-operated group (sham), the pacing-induced heart failure group (control), and the group treated with renal sympathetic denervation and rapid ventricular pacing (RSD). LV mechanical dyssynchrony was assessed using the standard deviation of the time from onset of the QRS interval to peak strain.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4255928&req=5

Fig1: LV dyssynchrony in three directions (radial, circumferential and longitudinal) in the sham-operated group (sham), the pacing-induced heart failure group (control), and the group treated with renal sympathetic denervation and rapid ventricular pacing (RSD). LV mechanical dyssynchrony was assessed using the standard deviation of the time from onset of the QRS interval to peak strain.
Mentions: Left ventricular strain and dyssynchrony were analyzed via two-dimensional speckle tracking echocardiography, using an ECHOPAC workstation as previously described [29]. Routine two-dimensional images were obtained via mid- and base-LV short-axis views and apical four- and two-chamber views at rates of 40–60 frames/s. The speckles of interest were followed throughout the entire cardiac cycle, and myocardial longitudinal, radial and circumferential deformation was each calculated automatically. Longitudinal strain of the LV (LVLS) was calculated as the average peak longitudinal strain across 12 segments of apical four- and two-chamber views. LV circumferential strain (LVCS) and LV radial strain (LVRS) were obtained from 12 segments of mid- and base-LV short-axis views. Mechanical dyssynchrony was assessed using the standard deviations of the time from onset of the QRS interval to the peak longitudinal strain of the LV (LV-Tls-12SD), the peak radial strain of the LV (LV-Trs-12SD) and the peak circumferential strain of the LV (LV-Tcs-12SD) (Figure 1).Figure 1

Bottom Line: The LV interstitial fibrosis was determined by histological analysis.The levels of LV dyssynchrony were lower in the RSD group than in the control group (p<0.001 for longitudinal, circumferential and radial dyssynchrony, respectively).The levels of plasma Ang II, aldosterone and NE were lower in the RSD group than in the control group.

View Article: PubMed Central - PubMed

Affiliation: Department of Ultrasound, Renmin Hospital of Wuhan University, Jiefang Road 238#, Wuchang District, Wuhan 430060, China. gzrdoct@163.com.

ABSTRACT

Background: The purpose of this study was to investigate whether transcatheter renal sympathetic denervation (RSD) interfere with the development of left ventricular (LV) mechanical dyssynchrony during the progression of heart failure (HF).

Methods: Nineteen beagles were randomly divided into sham-operated group (six dogs), control group (seven dogs), and RSD group (six dogs). Sham-operated group were implanted with pacemakers without pacing; Control group were implanted with pacemakers and underwent 3 weeks of rapid right ventricular pacing; and RSD group underwent catheter-based RSD bilaterally and were simultaneously implanted with pacemakers. Both LV strain and LV dyssynchrony were analyzed via 2D speckle-tracking strain echocardiography to evaluate LV function. Longitudinal dyssynchrony was determined as the standard deviation for time-to-peak speckle-tracking strain on apical 4- and 2-chamber views. Radial and circumferential dyssynchrony was determined as the standard deviation for time-to-peak speckle-tracking strain in mid- and base-LV short-axis views. Each myocardial function was also evaluated by averaging the peak systolic strains. LV systolic pressure (LVSP) and LV end-diastolic pressure (LVEDP) were measured. The LV interstitial fibrosis was determined by histological analysis. Plasma angiotensin II (Ang II), aldosterone and norepinephrine (NE) levels were also measured.

Results: After 3 weeks, all of the dogs in both the control and RSD groups showed greater LV end-diastolic volume compared with the sham-operated group; however, the dogs in the RSD group had a higher LV ejection fraction (LVEF) than the dogs in the control group (p<0.001). The LV systolic strains were higher in the RSD group than in the control group (p<0.001 for longitudinal, circumferential and radial strain, respectively). The levels of LV dyssynchrony were lower in the RSD group than in the control group (p<0.001 for longitudinal, circumferential and radial dyssynchrony, respectively). Compared with dogs with control alone, RSD dogs had lower LV end-diastolic pressures and less fibrous tissue. The levels of plasma Ang II, aldosterone and NE were lower in the RSD group than in the control group.

Conclusions: RSD inhibites the development of left ventricular mechanical dyssynchrony during the progression of heart failure in dogs.

Show MeSH
Related in: MedlinePlus