Department of Cardiology, Shanghai Ruijin Hospital Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
BMC Cardiovasc Disord. 2024 Oct 29;24(1):604. doi: 10.1186/s12872-024-04222-1.
This study aimed to explore the association between electrophysiological markers of early recurrence after defibrillation in post-myocardial infarction ventricular fibrillation and the therapeutic effects of sympathetic renal denervation, as well as to investigate the potential underlying mechanisms.
Experimental research was conducted using an animal model. Myocardial infarction was induced, followed by defibrillation treatment for ventricular fibrillation cases, and the electrophysiological markers of early recurrence were recorded. Subsequently, a subset of animals underwent sympathetic renal denervation intervention, and the therapeutic effects were compared between the sympathetic renal denervation group and the control group. Electrocardiogram monitoring, histological analysis of myocardial tissue, and neurotransmitter measurements were also performed.
Following defibrillation treatment, early recurrence was observed in ventricular fibrillation cases. The electrophysiological markers revealed significantly higher ST segment elevation and T wave changes in the early recurrence group. However, in the sympathetic renal denervation intervention group, the early recurrence rate was significantly reduced, and the electrocardiogram showed improved stability and regularity. Additionally, histological analysis of myocardial tissue demonstrated less cellular damage and lower levels of myocardial fibrosis in the sympathetic renal denervation group. Neurotransmitter measurements revealed a significant decrease in sympathetic nerve activity in the sympathetic renal denervation intervention group.
The results of this study indicate an association between electrophysiological markers of early recurrence after defibrillation in post-myocardial infarction ventricular fibrillation and the therapeutic effects of sympathetic renal denervation. Sympathetic renal denervation intervention can significantly reduce the early recurrence rate, improve electrocardiogram characteristics, and alleviate myocardial damage and fibrosis. Furthermore, the reduction in sympathetic nerve activity may be one of the potential underlying mechanisms of sympathetic renal denervation intervention.
本研究旨在探讨心肌梗死后室颤除颤后早期复发的电生理标志物与交感神经肾去神经支配治疗效果之间的关系,并探讨潜在的机制。
采用动物模型进行实验研究。诱导心肌梗死,随后对室颤进行除颤治疗,并记录早期复发的电生理标志物。随后,对一部分动物进行交感神经肾去神经支配干预,比较交感神经肾去神经支配组和对照组的治疗效果。还进行了心电图监测、心肌组织学分析和神经递质测量。
除颤治疗后,观察到室颤病例出现早期复发。电生理标志物显示早期复发组 ST 段抬高和 T 波变化明显更高。然而,在交感神经肾去神经支配干预组中,早期复发率显著降低,心电图显示稳定性和规律性得到改善。此外,心肌组织学分析显示交感神经肾去神经支配干预组的细胞损伤和心肌纤维化程度较低。神经递质测量显示交感神经肾去神经支配干预组的交感神经活性显著降低。
本研究结果表明,心肌梗死后室颤除颤后早期复发的电生理标志物与交感神经肾去神经支配的治疗效果之间存在关联。交感神经肾去神经支配干预可显著降低早期复发率,改善心电图特征,并减轻心肌损伤和纤维化。此外,交感神经活性的降低可能是交感神经肾去神经支配干预的潜在机制之一。