Division of Cardiology, Department of Medicine, Heart Rhythm Center, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan.
Institute of Clinical Medicine and Cardiovascular Research Institute, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Sci Rep. 2022 Feb 21;12(1):2904. doi: 10.1038/s41598-022-06882-5.
Long QT syndrome (LQTS) is commonly presented with life-threatening ventricular arrhythmias (VA). Renal artery denervation (RDN) is an alternative antiadrenergic treatment that attenuates sympathetic activity. We aimed to evaluate the efficacy of RDN on preventing VAs in LQTS rabbits induced by drugs. The subtypes of LQTS were induced by infusion of HMR-1556 for LQTS type 1 (LQT1), erythromycin for LQTS type 2 (LQT2), and veratridine for LQTS type 3 (LQT3). Forty-four rabbits were randomized into the LQT1, LQT2, LQT3, LQT1-RDN, LQT2-RDN, and LQT3-RDN groups. All rabbits underwent cardiac electrophysiology studies. The QTc interval of the LQT2-RDN group was significantly shorter than those in the LQT2 group (650.08 ± 472.67 vs. 401.78 ± 42.91 ms, p = 0.011). The QTc interval of the LQT3-RDN group was significantly shorter than those in the LQT3 group (372.00 ± 22.41 vs. 335.70 ± 28.21 ms, p = 0.035). The VA inducibility in all subtypes of the LQT-RDN groups was significantly lower than those in the LQT-RDN groups, respectively (LQT1: 9.00 ± 3.30 vs. 47.44 ± 4.21%, p < 0.001; LQT2: 11.43 ± 6.37 vs. 45.38 ± 5.29%, p = 0.026; LQT3: 10.00 ± 6.32 vs. 32.40 ± 7.19%, p = 0.006). This study demonstrated the neuromodulation of RDN leading to electrical remodeling and reduced VA inducibility of the ventricular substrate in LQT models.
长 QT 综合征(LQTS)常表现为危及生命的室性心律失常(VA)。肾动脉去神经支配(RDN)是一种抗肾上腺素能的替代治疗方法,可减轻交感神经活动。我们旨在评估 RDN 在预防药物诱导的 LQTS 兔 VA 中的疗效。LQTS 的亚型通过输注 HMR-1556 诱导 LQTS 1 型(LQT1),红霉素诱导 LQTS 2 型(LQT2),和藜芦碱诱导 LQTS 3 型(LQT3)。44 只兔子被随机分为 LQT1、LQT2、LQT3、LQT1-RDN、LQT2-RDN 和 LQT3-RDN 组。所有兔子均行心脏电生理研究。LQT2-RDN 组的 QTc 间期明显短于 LQT2 组(650.08±472.67 与 401.78±42.91 ms,p=0.011)。LQT3-RDN 组的 QTc 间期明显短于 LQT3 组(372.00±22.41 与 335.70±28.21 ms,p=0.035)。所有 LQT-RDN 组的 VA 易感性均明显低于相应的 LQT 组(LQT1:9.00±3.30 与 47.44±4.21%,p<0.001;LQT2:11.43±6.37 与 45.38±5.29%,p=0.026;LQT3:10.00±6.32 与 32.40±7.19%,p=0.006)。本研究表明,RDN 的神经调节作用导致 LQT 模型心室基质的电重构和 VA 易感性降低。