Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
Department of Cardiology, The Second Affiliated Hospital of Wannan Medical College, Wuhu, 241000, China.
Sci Rep. 2018 Jul 5;8(1):10206. doi: 10.1038/s41598-018-28562-z.
Ventricular arrhythmias (VAs) are the leading cause of sudden cardiac death in patients with myocardial infarction (MI). We sought to compare effects of renal denervation (RDN) and metoprolol on VAs after MI. Fifty-four male Sprague-Dawley rats underwent ligation of left anterior descending coronary artery to induce MI, while 6 rats served as Control. Metoprolol was given 20 mg/kg/day for 5 weeks after MI surgery. RDN/Sham-RDN procedure was performed at 1 week after MI. At 5 weeks after MI, electrical programmed stimulation (EPS) was performed in all groups for evaluation of VAs. After EPS, heart and kidneys were harvested. Compared with MI group, RDN and metoprolol significantly decreased the incidence of VAs, and RDN is superior to metoprolol. Compared with metoprolol group, Masson staining showed that RDN significantly reduced the myocardial fibrosis. Both RDN and metoprolol decreased the protein expression of connexin43 (Cx43) compared with MI group, while only RDN lighted this decrease remarkably. Immunohistochemical staining of Tyrosine hydroxylase (TH) and growth associated protein 43 (GAP43) revealed that RDN and metoprolol had similar effect on reducing densities of sympathetic nerve in infarction border zone. According to this study, RDN is more effective in reducing VAs than metoprolol in ischemic cardiomyopathy model.
室性心律失常(VA)是心肌梗死(MI)患者心源性猝死的主要原因。我们旨在比较肾去神经支配(RDN)和美托洛尔对 MI 后 VA 的影响。54 只雄性 Sprague-Dawley 大鼠通过结扎左前降支冠状动脉诱导 MI,同时 6 只大鼠作为对照。MI 手术后给予美托洛尔 20mg/kg/天 5 周。MI 后 1 周进行 RDN/假手术-RDN 手术。MI 后 5 周,所有组均进行电程控刺激(EPS)评估 VA。EPS 后,采集心脏和肾脏。与 MI 组相比,RDN 和美托洛尔显著降低了 VA 的发生率,RDN 优于美托洛尔。与美托洛尔组相比,Masson 染色显示 RDN 显著减少了心肌纤维化。与 MI 组相比,RDN 和美托洛尔均降低了连接蛋白 43(Cx43)的蛋白表达,但只有 RDN 显著降低了这种表达。酪氨酸羟化酶(TH)和生长相关蛋白 43(GAP43)的免疫组织化学染色显示,RDN 和美托洛尔对梗死交界区去交感神经密度的影响相似。根据这项研究,RDN 在缺血性心肌病模型中降低 VA 的效果优于美托洛尔。