Xiaokereti Jiasuoer, Guo Yankai, Liang Xiaoyan, Sun Huaxin, Li Kai, Zhang Ling, Tang Baopeng
Xinjiang Key Laboratory of Cardiac Electrophysiology and Cardiac Remodeling, The First Affiliated Hospital of Xinjiang Medical University, No.137, South Liyushan Road, Xinshi Zone, Urumqi, Xinjiang, China.
Cardiac Pacing and Electrophysiological Department, The First Affiliated Hospital of Xinjiang Medical University, No.137, South Liyushan Road, Xinshi Zone, Urumqi, Xinjiang, China.
Sleep Breath. 2023 Oct;27(5):1805-1818. doi: 10.1007/s11325-023-02784-6. Epub 2023 Feb 22.
Previous studies have reported that renal denervation (RDN) prevents the occurrence of atrial fibrillation (AF) related to obstructive sleep apnea (OSA). However, the effect of RDN on chronic OSA (COSA)-induced AF is still unclear.
Healthy beagle dogs were randomized into the OSA group (sham RDN + OSA), OSA-RDN group (RDN + OSA), and CON group (sham RDN + sham OSA). The COSA model was built via repeated apnea and ventilation rounds for 4 h each day lasting 12 weeks, and RDN was employed after 8 weeks of modeling. All dogs were implanted Reveal LINQ™ to detect spontaneous AF and AF burden. Circulating levels of norepinephrine, angiotensin II, and interleukin-6 were determined at baseline and end of the study. In addition, measurements of the left stellate ganglion, AF inducibility, and effective refractory period were conducted. The bilateral renal artery and cortex, left stellate ganglion, and left atrial tissues were collected for molecular analysis.
Of 18 beagles, 6 were randomized to each of the groups described above. RDN remarkably attenuated ERP prolongation and AF episodes and duration. RDN markedly suppressed the LSG hyperactivity and atrial sympathetic innervation, decreased the serum concentrations of Ang II and IL-6, further inhibited fibroblast-to-myofibroblast transformation via the TGF-β1/Smad2/3/α-SMA pathway, and reduced the expression of MMP-9, thus decreasing OSA-induced AF.
RDN may reduce AF by inhibiting sympathetic hyperactivity and AF in a COSA model.
既往研究报道，肾去神经支配（RDN）可预防与阻塞性睡眠呼吸暂停（OSA）相关的心房颤动（AF）的发生。然而，RDN对慢性OSA（COSA）诱发的AF的影响仍不明确。
将健康的比格犬随机分为OSA组（假手术RDN+OSA）、OSA-RDN组（RDN+OSA）和CON组（假手术RDN+假手术OSA）。通过每天重复进行4小时的呼吸暂停和通气循环，持续12周建立COSA模型，并在建模8周后进行RDN。所有犬均植入Reveal LINQ™以检测自发性AF和AF负荷。在基线和研究结束时测定去甲肾上腺素、血管紧张素II和白细胞介素-6的循环水平。此外，还进行了左侧星状神经节、AF诱发性和有效不应期的测量。收集双侧肾动脉和皮质、左侧星状神经节和左心房组织进行分子分析。
18只比格犬中，每组随机分配6只。RDN显著减轻ERP延长以及AF发作和持续时间。RDN显著抑制LSG活性亢进和心房交感神经支配，降低血清Ang II和IL-6浓度，通过TGF-β1/Smad2/3/α-SMA途径进一步抑制成纤维细胞向肌成纤维细胞转化，并降低MMP-9的表达，从而减少OSA诱发的AF。
在COSA模型中，RDN可能通过抑制交感神经活性亢进和AF来减少AF。
