Pinkham Maximilian I, Loftus Michael T, Amirapu Satya, Guild Sarah-Jane, Quill Gina, Woodward William R, Habecker Beth A, Barrett Carolyn J
Department of Physiology, University of Auckland, Auckland, New Zealand.
Department of Anatomy and Radiology, University of Auckland, Auckland, New Zealand.
Am J Physiol Regul Integr Comp Physiol. 2017 Mar 1;312(3):R368-R379. doi: 10.1152/ajpregu.00313.2016. Epub 2017 Jan 4.
Heart failure is characterized by the loss of sympathetic innervation to the ventricles, contributing to impaired cardiac function and arrhythmogenesis. We hypothesized that renal denervation (RDx) would reverse this loss. Male Wistar rats underwent myocardial infarction (MI) or sham surgery and progressed into heart failure for 4 wk before receiving bilateral RDx or sham RDx. After additional 3 wk, left ventricular (LV) function was assessed, and ventricular sympathetic nerve fiber density was determined via histology. Post-MI heart failure rats displayed significant reductions in ventricular sympathetic innervation and tissue norepinephrine content (nerve fiber density in the LV of MI+sham RDx hearts was 0.31 ± 0.05% vs. 1.00 ± 0.10% in sham MI+sham RDx group, < 0.05), and RDx significantly increased ventricular sympathetic innervation (0.76 ± 0.14%, < 0.05) and tissue norepinephrine content. MI was associated with an increase in fibrosis of the noninfarcted ventricular myocardium, which was attenuated by RDx. RDx improved LV ejection fraction and end-systolic and -diastolic areas when compared with pre-RDx levels. This is the first study to show an interaction between renal nerve activity and cardiac sympathetic nerve innervation in heart failure. Our findings show denervating the renal nerves improves cardiac sympathetic innervation and function in the post-MI failing heart.
心力衰竭的特征是心室交感神经去神经支配丧失,这会导致心脏功能受损和心律失常。我们假设肾去神经支配(RDx)可以逆转这种丧失。雄性Wistar大鼠接受心肌梗死(MI)或假手术,在进展为心力衰竭4周后接受双侧RDx或假RDx。再过3周后,评估左心室(LV)功能,并通过组织学测定心室交感神经纤维密度。MI后心力衰竭大鼠的心室交感神经支配和组织去甲肾上腺素含量显著降低(MI+假RDx组LV的神经纤维密度为0.31±0.05%,而假MI+假RDx组为1.00±0.10%,P<0.05),而RDx显著增加了心室交感神经支配(0.76±0.14%,P<0.05)和组织去甲肾上腺素含量。MI与非梗死心室心肌纤维化增加有关,而RDx可减轻这种纤维化。与RDx前水平相比,RDx改善了LV射血分数以及收缩末期和舒张末期面积。这是第一项显示心力衰竭中肾神经活动与心脏交感神经支配之间相互作用的研究。我们的研究结果表明,对肾神经进行去神经支配可改善MI后衰竭心脏的心脏交感神经支配和功能。