Pulmonary artery denervation improves pulmonary arterial hypertension induced right ventricular dysfunction by modulating the local renin-angiotensin-aldosterone system

BMC Cardiovascular Disorders

Research Article

Zuo-Ying Hu¹  Chen Liu¹  Bing Li¹  Jing Li¹  Du-Jiang Xie²  Juan Zhang²  Xiao-Min Jiang² 

[1] Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, 68# Changle Road, 210006, Nanjing, China;Division of Cardiology, Nanjing First Hospital, 68# Changle Road, 210006, Nanjing, China;

关键词: Pulmonary artery denervation;    Pulmonary arterial hypertension;    Right ventricular dysfunction;    Renin–angiotensin–aldosterone system;   

DOI  :  10.1186/s12872-016-0366-4

 received in 2016-06-08, accepted in 2016-09-28,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundPulmonary arterial hypertension (PAH) is commonly accompanied with the activation of the renin-angiotensin-aldosterone system (RAAS). Renal sympathetic denervation (RSD) reduces PAH partly through the inhibition of RAAS. Analogically, we hypothesized that pulmonary artery denervation (PADN) could reverse PAH and PAH-induced right ventricular (RV) dysfunction by downregulating the local RAAS activity.MethodsTwenty-five beagle dogs were randomized into two groups: control group (intra-atrial injection of N-dimethylacetamide, 3 mg/kg, n = 6) and test group (intra-atrial injection of dehydrogenized-monocrotaline, 3 mg/kg, n = 19). Eight weeks later, dogs in the test group with mean pulmonary arterial pressure (mPAP) ≥25 mmHg (n = 16) were reassigned into the sham (n = 8) and PADN groups (n = 8) by chance. After another 6 weeks, the hemodynamics, pulmonary tissue morphology and the local RAAS expression in lung and right heart tissue were measured.ResultsPADN reduced the mPAP (25.94 ± 3.67 mmHg vs 33.72 ± 5.76 mmHg, P < 0.05) and the percentage of medial wall thickness (%MWT) (31.0 ± 2.6 % vs 37.9 ± 2.8 %, P < 0.05) compared with the sham group. PADN attenuated RV dysfunction, marked with reduced atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP) and ratio of right ventricular to left ventricular plus septum weight [RV/(LV + S)]. Moreover, the local RAAS expression was activated in PAH dogs while inhibited after PADN.ConclusionsPADN improves hemodynamics and relieves RV dysfunction in dogs with PAH, which can be associated with the downregulating RAAS activity in local tissue.

【 授权许可】

CC BY   
© The Author(s). 2016