Abstract 11531: Beneficial Effects of Renal Sympathetic Denervation on Pulmonary Vascular Remodeling and Left Ventricular Function in Experimental Pulmonary Artery Hypertension
Introduction: The sympathetic nervous system and renin-angiotensin-aldosterone system (RAAS) have been reported to be activated in pulmonary arterial hypertension (PAH).
Hypothesis: This study tested the hypothesis that renal sympathetic denervation (RSD) decrease RAAS activity and inhibit pulmonary vascular remodeling in experimental PAH.
Methods: Nineteen beagles were randomized into control (n=6), PAH (n=7) and PAH[[Unable to Display Character: ]]RSD (n=6) groups. Animals underwent percutaneous pulmonary artery catheterization to measure pulmonary hemodynamics before and 8 weeks after injection of 0.1 ml/kg dimethylformamide (Control dogs) or 2 mg/kg dehydromonocrotaline (PAH and PAH[[Unable to Display Character: ]]RSD dogs). The dogs in the PAH[[Unable to Display Character: ]]RSD group received double renal artery ablation before injection. Eight weeks after injection, levels of Angiotensin II (Ang II), pulmonary arterial tissue morphology and cardiac function were measured.
Results: The levels of Ang II in plasma and pulmonary arterial tissue were significantly increased in PAH group compared with control group and PAH[[Unable to Display Character: ]]RSD group after 8 weeks. Dehydromonocrotaline increased mean pulmonary arterial pressure (15 ± 4.1 mmHg vs. 34 ± 9.7 mmHg, P <0 .01), and this increase was prevented by RSD (14 ± 3.7 mmHg vs. 17 ± 5.5 mmHg, P=0.35). Pulmonary fibrous tissue and smooth muscle cell proliferation were less in the PAH[[Unable to Display Character: ]]RSD group than in the PAH group. Right ventricular end-diastolic diameter and right ventricular free wall systolic thickness were significantly lower in the PAH[[Unable to Display Character: ]]RSD group compared with the PAH group.
Conclusions: RSD suppressed the pulmonary vascular remodeling and decrease the pulmonary arterial pressure in experimental PAH.
Keywords: pulmonary arterial hypertension; ablation; renal sympathetic nerve; renin-angiotensin-aldosterone system
- © 2013 by American Heart Association, Inc.