Acute changes in morphology and renal vascular relaxation function after renal denervation using temperature-controlled radiofrequency catheter
Acute changes in morphology and renal vascular relaxation function after renal denervation using temperature-controlled radiofrequency catheter
复制标题
温控射频导管肾去神经术后形态和肾血管舒张功能的急性变化
DOI：
10.1186/s12872-019-1053-z
复制
发表时间：
2019-03-22
影响因子：
2.1
通讯作者：
Liu, Yahui
中科院分区：
文献类型：
--
作者：
Su, Enyong;Zhao, Linwei;Liu, Yahui
研究背景难治性高血压与肾交感神经亢进密切相关，基于导管的肾去神经术（RDN）被视为一种新的治疗策略。然而，血管形态和松弛功能的急性变化尚未评估，这些可能对于手术的有效性和安全性很重要。在本研究中，我们通过基于常规温控心脏射频导管的RDN猪模型来探讨这些问题。方法将6只小型猪随机分为肾去神经术（RDN）组（n= 3）和Sham-RDN组（n= 3）。 RDN组的动物接受单侧射频消融，Sham-RDN组的动物除消融外接受相同的手术。在RDN之前和之后对猪进行血管造影检查，然后立即对它们实施安乐死。处理肾动脉进行组织学和分子生物学分析以及体外血管张力测试。结果与Sham-RDN组相比，RDN引起血管内膜和中层损伤，肾神经空泡化，轻度胶原纤维增生和弹力纤维裂解（均p<0.05）。与Sham-RDN组相比，RDN组还显着表现出一氧化氮合酶途径抑制和内皮依赖性血管舒张功能下降（均p<0.05）。结论在该猪模型中，肾动脉去神经导致急性期血管壁损伤和内皮功能障碍，从而对血管舒张功能产生负面影响。因此，这一过程可能不利于高血压患者的预后和进展。
BackgroundResistant hypertension and renal sympathetic hyperactivity are closely linked, and catheter-based renal denervation (RDN) is regarded as a new treatment strategy. However, the acute changes in vascular morphology and relaxation function have yet to be evaluated, and these may be important for the efficacy and safety of the procedure. In this study, we explored these questions by conventional temperature-controlled cardiac radiofrequency catheter-based RDN in a pig model.MethodsSix mini-pigs were randomly divided into the renal denervation (RDN) group (n= 3) and the Sham-RDN group (n= 3). Animals in the RDN group underwent unilateral radiofrequency ablation, and those in the Sham-RDN group underwent the same procedure except for the ablation. The pigs were examined by angiography pre- and post-RDN and were euthanized immediately thereafter. Renal arteries were processed for histological and molecular biology analyses as well as for in vitro vascular tension testing.ResultsCompared with the Sham-RDN group, the RDN caused vascular intima and media injury, renal nerve vacuolization, mild collagen fiber hyperplasia and elastic fiber cleavage (allp< 0.05). The RDN group also significantly exhibited nitric oxide synthase pathway inhibition and decreased endothelium-independent vascular relaxation function Compared to the Sham-RDN group (allp< 0.05).ConclusionsIn this porcine model, renal artery denervation led to vascular wall injury and endothelial dysfunction in the acute phase, which negatively affected vascular relaxation function. Thus, this process may be detrimental to the prognosis and progress of hypertension patients.