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肾动脉血管扩张可能是肾去神经术成功损伤交感神经的指标。

Renal Artery Vasodilation May Be An Indicator of Successful Sympathetic Nerve Damage During Renal Denervation Procedure.

机构信息

Department of Cardiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing Cardiac Arrhythmias Therapeutic Service Center, Chongqing, China.

Department of Cardiolgy, Chongqing Province Hospital of Traditional Chinese Medicine, Chongqing, China.

出版信息

Sci Rep. 2016 Nov 16;6:37218. doi: 10.1038/srep37218.

Abstract

Autonomic nervous system plays a crucial role in maintaining and regulating vessel tension. Renal denervation (RDN) may induce renal artery vasodilation by damaging renal sympathetic fibers. We conducted this animal study to evaluate whether renal artery vasodilation could be a direct indicator of successful RDN. Twenty-eight Chinese Kunming dogs were randomly assigned into three groups and underwent RDN utilizing temperature-controlled catheter (group A, n = 11) or saline-irrigated catheter (group B, n = 11) or sham procedure (group C, n = 6). Renal angiography, blood pressure (BP) and renal artery vasodilation measurements were performed at baseline, 30-minute, 1-month, and 3-month after interventions. Plasma norepinephrine concentrations were tested at baseline and 3-month after intervention. Results showed that, in addition to significant BP reduction, RDN induced significant renal artery vasodilation. Correlation analyses showed that the induced renal artery vasodilation positively correlated with SBP reduction and plasma norepinephrine reduction over 3 months after ablation. Post hoc analyses showed that saline-irrigated catheter was superior to TC catheter in renal artery vasodilation, especially for the acute dilatation of renal artery at 30-minute after RDN. In conclusion, renal artery vasodilation, induced by RDN, may be a possible indicator of successful renal nerve damage and a predictor of blood pressure response to RDN.

摘要

自主神经系统在维持和调节血管张力方面起着至关重要的作用。肾去神经支配(RDN)可能通过损伤肾交感神经纤维引起肾动脉扩张。我们进行了这项动物研究,以评估肾动脉扩张是否可以成为 RDN 成功的直接指标。28 只中国昆明犬被随机分为三组,分别接受温度控制导管(A 组,n=11)或盐水冲洗导管(B 组,n=11)或假手术(C 组,n=6)的 RDN。在干预前、干预后 30 分钟、1 个月和 3 个月时进行肾血管造影、血压(BP)和肾动脉扩张测量,并在干预前和干预后 3 个月时检测血浆去甲肾上腺素浓度。结果表明,除了显著降低血压外,RDN 还可诱导显著的肾动脉扩张。相关分析表明,消融后 3 个月内诱导的肾动脉扩张与 SBP 降低和血浆去甲肾上腺素降低呈正相关。事后分析表明,与 TC 导管相比,盐水冲洗导管在肾动脉扩张方面更具优势,尤其是在 RDN 后 30 分钟时肾动脉的急性扩张。总之,RDN 诱导的肾动脉扩张可能是肾神经损伤成功的一个可能指标,也是 RDN 对血压反应的预测指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/87d8/5110962/27fe8e18be52/srep37218-f1.jpg

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