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Renal denervation suppresses atrial fibrillation in a model of renal impairment.

Liang Z, Shi XM, Liu LF, Chen XP, Shan ZL, Lin K, Li J, Chen FK, Li YG, Guo HY, Wang YT - PLoS ONE (2015)

Bottom Line: The main objective of the study was to explore the effects of RDN on AF occurrence and its possible mechanisms in beagles with RI.Cardiac electrophysiological parameters, blood pressure, left ventricular end-diastolic pressure, and AF inducibility were investigated.Heart rate, P wave duration and BP were increased by RI, which were prevented or attenuated by RDN.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Chinese PLA General Hospital, Beijing, China.

ABSTRACT

Background: A close association exists between renal impairment (RI) and atrial fibrillation (AF) occurrence. Increased activity of the sympathetic nervous system (SNS) may contribute to the development of AF associated with RI. Renal denervation (RDN) decreases central sympathetic activity.

Objective: The main objective of the study was to explore the effects of RDN on AF occurrence and its possible mechanisms in beagles with RI.

Methods: Unilateral RI was induced in beagles by embolization of small branches of the renal artery in the right kidney using gelatin sponge granules in Model (n = 6) and RDN group (n = 6). The Sham group (n = 6) underwent the same procedure, except for embolization. Then animals in RDN group underwent radiofrequency ablation of the renal sympathetic nerve. Cardiac electrophysiological parameters, blood pressure, left ventricular end-diastolic pressure, and AF inducibility were investigated. The activity of the SNS, renin-angiotensin-aldosterone system (RAAS), inflammation and atrial interstitial fibrosis were measured.

Results: Embolization of small branches of the renal artery in the right kidney led to ischemic RI. Heart rate, P wave duration and BP were increased by RI, which were prevented or attenuated by RDN. Atrial effective refractory period was shortened and AF inducibility was increased by RI, which were prevented by RDN. Antegrade Wenckebach point was shortened, atrial and ventricular rates during AF were increased by RI, which were attenuated or prevented by RDN. Levels of norepinephrine, renin and aldosterone in plasma, norepinephrine, angiotensin II, aldosterone, interleukin-6 and high sensitivity C-reactive protein in atrial tissue were elevated, and atrial interstitial fibrosis was enhanced by RI, which were attenuated by RDN.

Conclusions: RDN significantly reduced AF inducibility, prevented the atrial electrophysiological changes in a model of RI by combined reduction of sympathetic drive and RAAS activity, and inhibition of inflammation activity and fibrotic pathway in atrial tissue.

No MeSH data available.


Related in: MedlinePlus

Analysis of the activity of RAAS.Effects of RDN on the changes of plasma levels of renin (A) and aldosterone (B) between values of 2 weeks and baseline (n = 6). Left atrial angiotensin II (C) and aldosterone (D) levels in the three groups (n = 6).
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pone.0124123.g008: Analysis of the activity of RAAS.Effects of RDN on the changes of plasma levels of renin (A) and aldosterone (B) between values of 2 weeks and baseline (n = 6). Left atrial angiotensin II (C) and aldosterone (D) levels in the three groups (n = 6).

Mentions: Sham operation did not change the plasma levels of renin and aldosterone after 2 weeks, compared with the baseline values in the Sham group. In contrast, 2 weeks of RI induced a pronounced increase in plasma levels of renin and aldosterone by 56.2% and 59.9% respectively, compared with the baseline values in the Model group (P < 0.05 for each). RDN reduced RI-induced increase in plasma levels of renin and aldosterone by 47.3% and 57.1% respectively (P < 0.05 for each) (Fig 8A and 8B). Levels of angiotensin II and aldosterone in left atrial tissue were shown in Fig 8C and 8D, respectively. Compared with the Sham group, left atrial tissue levels of angiotensin II and aldosterone were increased by 61.3% and 67.1% respectively in the Model group (P < 0.05 for each). In the RDN group, levels of angiotensin II and aldosterone were reduced by 16.9% and 20% respectively, compared with the Model group (P < 0.05 for each).


Renal denervation suppresses atrial fibrillation in a model of renal impairment.

Liang Z, Shi XM, Liu LF, Chen XP, Shan ZL, Lin K, Li J, Chen FK, Li YG, Guo HY, Wang YT - PLoS ONE (2015)

Analysis of the activity of RAAS.Effects of RDN on the changes of plasma levels of renin (A) and aldosterone (B) between values of 2 weeks and baseline (n = 6). Left atrial angiotensin II (C) and aldosterone (D) levels in the three groups (n = 6).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4401704&req=5

pone.0124123.g008: Analysis of the activity of RAAS.Effects of RDN on the changes of plasma levels of renin (A) and aldosterone (B) between values of 2 weeks and baseline (n = 6). Left atrial angiotensin II (C) and aldosterone (D) levels in the three groups (n = 6).
Mentions: Sham operation did not change the plasma levels of renin and aldosterone after 2 weeks, compared with the baseline values in the Sham group. In contrast, 2 weeks of RI induced a pronounced increase in plasma levels of renin and aldosterone by 56.2% and 59.9% respectively, compared with the baseline values in the Model group (P < 0.05 for each). RDN reduced RI-induced increase in plasma levels of renin and aldosterone by 47.3% and 57.1% respectively (P < 0.05 for each) (Fig 8A and 8B). Levels of angiotensin II and aldosterone in left atrial tissue were shown in Fig 8C and 8D, respectively. Compared with the Sham group, left atrial tissue levels of angiotensin II and aldosterone were increased by 61.3% and 67.1% respectively in the Model group (P < 0.05 for each). In the RDN group, levels of angiotensin II and aldosterone were reduced by 16.9% and 20% respectively, compared with the Model group (P < 0.05 for each).

Bottom Line: The main objective of the study was to explore the effects of RDN on AF occurrence and its possible mechanisms in beagles with RI.Cardiac electrophysiological parameters, blood pressure, left ventricular end-diastolic pressure, and AF inducibility were investigated.Heart rate, P wave duration and BP were increased by RI, which were prevented or attenuated by RDN.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Chinese PLA General Hospital, Beijing, China.

ABSTRACT

Background: A close association exists between renal impairment (RI) and atrial fibrillation (AF) occurrence. Increased activity of the sympathetic nervous system (SNS) may contribute to the development of AF associated with RI. Renal denervation (RDN) decreases central sympathetic activity.

Objective: The main objective of the study was to explore the effects of RDN on AF occurrence and its possible mechanisms in beagles with RI.

Methods: Unilateral RI was induced in beagles by embolization of small branches of the renal artery in the right kidney using gelatin sponge granules in Model (n = 6) and RDN group (n = 6). The Sham group (n = 6) underwent the same procedure, except for embolization. Then animals in RDN group underwent radiofrequency ablation of the renal sympathetic nerve. Cardiac electrophysiological parameters, blood pressure, left ventricular end-diastolic pressure, and AF inducibility were investigated. The activity of the SNS, renin-angiotensin-aldosterone system (RAAS), inflammation and atrial interstitial fibrosis were measured.

Results: Embolization of small branches of the renal artery in the right kidney led to ischemic RI. Heart rate, P wave duration and BP were increased by RI, which were prevented or attenuated by RDN. Atrial effective refractory period was shortened and AF inducibility was increased by RI, which were prevented by RDN. Antegrade Wenckebach point was shortened, atrial and ventricular rates during AF were increased by RI, which were attenuated or prevented by RDN. Levels of norepinephrine, renin and aldosterone in plasma, norepinephrine, angiotensin II, aldosterone, interleukin-6 and high sensitivity C-reactive protein in atrial tissue were elevated, and atrial interstitial fibrosis was enhanced by RI, which were attenuated by RDN.

Conclusions: RDN significantly reduced AF inducibility, prevented the atrial electrophysiological changes in a model of RI by combined reduction of sympathetic drive and RAAS activity, and inhibition of inflammation activity and fibrotic pathway in atrial tissue.

No MeSH data available.


Related in: MedlinePlus