Almazov National Medical Research Centre, Saint Petersburg, Russia.
Biomed Res Int. 2021 Nov 2;2021:4248111. doi: 10.1155/2021/4248111. eCollection 2021.
We aimed to assess the effects of renal denervation (RDN) on systemic and pulmonary hemodynamics in a swine model of thromboxane A2- (TXA2-) induced pulmonary arterial hypertension (PAH).
The study protocol comprised two PAH inductions with a target mean pulmonary artery pressure (PAP) of 40 mmHg at baseline and following either the RDN or sham procedure. Ten Landrace pigs underwent the first PAH induction; then, nine animals were randomly allocated in 1 : 1 ratio to RDN or sham procedure; the second PAH induction was performed in eight animals (one animal died of pulmonary embolism during the first PAH induction, and one animal died after RDN). In the RDN group, ablation was performed in all available renal arteries, and balloon inflation within artery branches was performed in controls. An autopsy study of the renal arteries was performed.
At baseline, the target mean PAP was achieved in all animals with 25.0 [20.1; 25.2] mcg of TXA2. The second PAH induction required the same mean TXA2 dose and infusion time. There was no statistically significant difference in the mean PAP at second PAH induction between the groups (39.0 ± 5.3 vs. 39.75 ± 0.5 mmHg, > 0.05). In the RDN group, the second PAH induction resulted in a numerical but insignificant trend toward a decrease in the mean systemic blood pressure and systemic vascular resistance, when compared with the baseline induction (74 ± 18.7 vs. 90.25 ± 28.1 mmHg and 1995.3 ± 494.3 vs. 2433.7 ± 1176.7 ∗sec∗ , > 0.05, respectively). No difference in hemodynamic parameters was noted in the sham group between the first and second PAH induction. Autopsy demonstrated artery damage in both groups, but RDN resulted in more severe lesions.
According to our results, RDN does not result in significant acute pulmonary or systemic hemodynamic changes in the TXA2-induced PAH model. The potential chronic effects of RDN on PAH require further research.
我们旨在评估肾去神经支配（RDN）对血栓素 A2-（TXA2-）诱导肺动脉高压（PAH）猪模型中全身和肺循环动力学的影响。
该研究方案包括两次 PAH 诱导，基础值和随后的 RDN 或假手术时的目标平均肺动脉压（PAP）均为 40mmHg。10 头长白猪接受第一次 PAH 诱导；然后，将 9 只动物随机分为 1:1 比例的 RDN 或假手术组；8 只动物进行第二次 PAH 诱导（第一次 PAH 诱导期间 1 只动物死于肺栓塞，1 只动物在 RDN 后死亡）。在 RDN 组中，对所有可用的肾动脉进行消融，在对照中对动脉分支内的球囊充气。对肾动脉进行尸检研究。
在基线时，所有动物均用 25.0[20.1; 25.2]mcg TXA2 达到目标平均 PAP。第二次 PAH 诱导需要相同的平均 TXA2 剂量和输注时间。两组之间第二次 PAH 诱导时的平均 PAP 无统计学差异（39.0±5.3 与 39.75±0.5mmHg，>0.05）。在 RDN 组中，与基础诱导相比，第二次 PAH 诱导时平均全身血压和全身血管阻力呈数值但无显著降低趋势（74±18.7 与 90.25±28.1mmHg 和 1995.3±494.3 与 2433.7±1176.7∗sec∗，>0.05）。假手术组在第一次和第二次 PAH 诱导之间的血流动力学参数无差异。尸检显示两组均有动脉损伤，但 RDN 导致更严重的损伤。
根据我们的结果，RDN 在 TXA2 诱导的 PAH 模型中不会导致明显的急性肺或全身血流动力学变化。RDN 对 PAH 的潜在慢性影响需要进一步研究。
