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肾去神经支配对心肌梗死大鼠睡眠呼吸暂停和心律失常的影响。

Effects of renal denervation on sleep apnea and arrhythmia in rats with myocardial infarction.

作者信息

Lin Wei-Lun, Lai Chun-Ting, Yamada Shinya, Liu Shin-Huei, Cheng Wen-Han, Chou Yu-Hui, Yang Cheryl C H, Kuo Terry B J, Chen Shih-Ann, Lo Li-Wei

机构信息

Heart Rhythm Center, Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Clinical Medicine, National Yang Ming Chiou Tung University, Taipei, Taiwan; Institute of Biomedical Sciences, MacKay Medical College, New Taipei City, Taiwan.

Institute of Brain Science, National Yang Ming Chiou Tung University, Taipei, Taiwan.

出版信息

Sleep Med. 2022 Mar;91:115-123. doi: 10.1016/j.sleep.2021.11.017. Epub 2022 Feb 11.

Abstract

BACKGROUND

Sympathetic hyperactivity and poor sleep quality have been reported in patients with myocardial infarction (MI). Sleep is an important modulator of cardiovascular function. We aimed to evaluate the effects of renal denervation (RDN) on cardiac autonomic activity and disordered sleep patterns in rats with MI.

METHODS

Wireless transmission of polysomnographic recordings was performed in sham and left coronary artery (LCA) ligation male rats during normal daytime sleep before and after RDN. Spectral analyses of electroencephalogram and electromyogram (EMG) recordings were performed to define active waking, quiet sleep, and paradoxical sleep. Cardiac autonomic activity was measured by analyzing the power spectrum of heart rate variability. Central sleep apnea events were measured by analyzing the EMG recordings of the diaphragm.

RESULTS

In the LCA ligation group, there was a higher low-frequency (LF)/high-frequency (HF) power ratio during sleep; the LF/HF ratio decreased significantly in the rats that underwent RDN in all sleep stages when compared with that in the rats that did not. The frequency of sleep interruptions increased without RDN in the LCA ligation group when compared with that in the sham group. This change was ameliorated and prevented with RDN in the LCA ligation group.

CONCLUSIONS

Our results demonstrate significant sleep fragmentation with sympathetic hyperactivity after MI and that RDN prevents autonomic dysfunction and disordered sleep. RDN may then reduce sleep apnea and sleep-related sudden cardiac death after MI by restoring autonomic homeostasis.

摘要

背景

心肌梗死(MI)患者中已报道存在交感神经过度活跃和睡眠质量差的情况。睡眠是心血管功能的重要调节因素。我们旨在评估肾去神经支配(RDN)对MI大鼠心脏自主神经活动和睡眠模式紊乱的影响。

方法

在RDN前后的正常白天睡眠期间,对假手术组和左冠状动脉(LCA)结扎的雄性大鼠进行多导睡眠图记录的无线传输。对脑电图和肌电图(EMG)记录进行频谱分析,以定义清醒、安静睡眠和异相睡眠。通过分析心率变异性的功率谱来测量心脏自主神经活动。通过分析膈肌的EMG记录来测量中枢性睡眠呼吸暂停事件。

结果

在LCA结扎组中,睡眠期间低频(LF)/高频(HF)功率比更高;与未接受RDN的大鼠相比,接受RDN的大鼠在所有睡眠阶段的LF/HF比均显著降低。与假手术组相比,LCA结扎组未进行RDN时睡眠中断频率增加。LCA结扎组进行RDN后,这种变化得到改善并得到预防。

结论

我们的结果表明,MI后存在显著的睡眠碎片化和交感神经过度活跃,而RDN可预防自主神经功能障碍和睡眠紊乱。RDN可能通过恢复自主神经稳态来减少MI后的睡眠呼吸暂停和与睡眠相关的心脏性猝死。

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