Renal Denervation Decreases Susceptibility to Arrhythmogenic Cardiac Alternans and Ventricular Arrhythmia in a Rat Model of Post-Myocardial Infarction Heart Failure
| Autor: | Jiunn Lee Lin, Juey-Jen Hwang, Ling Ping Lai, Shu Hsuan Chang, Fu-Tien Chiang, Sheng-Nan Chang, Chia Ti Tsai, Chih Chieh Yu, Cho-Kai Wu |
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| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
lcsh:Diseases of the circulatory (Cardiovascular) system medicine.medical_specialty RDN renal denervation heart failure Infarction Hemodynamics 030204 cardiovascular system & hematology HF heart failure PRECLINICAL RESEARCH 03 medical and health sciences 0302 clinical medicine APD action potential duration Optical mapping Internal medicine VT ventricular tachycardia APD-ALT action potential duration alternans Medicine Repolarization cardiovascular diseases renal denervation Denervation arrhythmia mechanism Ca-ALT calcium transient alternans alternans business.industry medicine.disease PR pacing rate 030104 developmental biology Blood pressure lcsh:RC666-701 SCD sudden cardiac death Heart failure Ventricular fibrillation MI myocardial infarction cardiovascular system Cardiology VF ventricular fibrillation Cardiology and Cardiovascular Medicine business |
| Zdroj: | JACC: Basic to Translational Science JACC: Basic to Translational Science, Vol 2, Iss 2, Pp 184-193 (2017) |
| ISSN: | 2452-302X |
| DOI: | 10.1016/j.jacbts.2017.01.008 |
| Popis: | Visual Abstract Highlights • In systolic heart failure, decreased renal perfusion due to impaired cardiac pumping activates the renal nerves, which send a signal to the brain to call for help. • The brain thus activates the neurohormonal system to increase organ perfusion, which may predispose the heart to ventricular arrhythmia. • Chemical renal denervation with phenol cuts the signal sent to the brain and thus decreases the susceptibility to ventricular arrhythmia in rats with systolic heart failure. Summary Several studies have shown the beneficial effect of renal denervation (RDN) in the treatment of ventricular arrhythmia, especially in the setting of heart failure (HF). However, the underlying mechanism of antiarrhythmic effect of RDN is unknown. Arrhythmogenic cardiac alternans, particularly spatially discordant repolarization alternans, characterized by simultaneous prolongation and shortening of action potential duration (APD) in different myocardial regions, is central to the genesis of ventricular fibrillation in HF. Whether RDN decreases the susceptibility to arrhythmogenic cardiac alternans in HF has never been addressed before. The authors used a rat model of post-myocardial infarction HF and dual voltage-calcium optical mapping to investigate whether RDN could attenuate arrhythmogenic cardiac alternans that predisposes to ventricular arrhythmias, as well as the hemodynamic effect of RDN in HF. The HF rats had increased body weights, dilated hearts, and lower blood pressure. The HF rats also had longer ventricular APDs and a delay in the decay of the calcium transient, typical electrophysiological features of human HF. Susceptibility to calcium transient alternans, APD alternans, and spatially discordant APD alternans was increased in the HF hearts. RDN significantly attenuated a delay in the decay of the calcium transient, calcium transient and APD alternans, and importantly, the discordant APD alternans, and thereby decreased the incidence of induced ventricular arrhythmia in HF. RDN did not further decrease blood pressure in HF rats. In conclusion, RDN improves calcium cycling and prevents spatially discordant APD alternans and ventricular arrhythmia in HF. RDN does not aggravate hemodynamics in HF. |
| Databáze: | OpenAIRE |
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