Effect Of Renal Denervation On Heart Failure After Myocardial Infarction In Dogs

Objective: To elucidate the efficacy and feasibility of renal denervation(RDN)in the treatment of heart failure after myocardial infarction,and to provide new ideas and methods for the treatment of heart failure.Methods: The experimental animals were randomly divided into two groups: MI Group(n=12)and Sham Operation Group(n=6),MI group ligation coronary artery to construct canine myocardial infarction(MI)model,the sham operation group only did the same invasive operation,not ligation coronary artery.After 4 weeks of postoperative recovery,the canine was randomly divided into two groups: MI Group(n=6)and MI+RDN treatment Group(n=6).The MI+RDN group was damaged bilateral renal sympathetic nerves,and the MI group was only given the same open abdominal operation without damaging bilateral renal sympathetic nerves.Preoperation and Postoperative 1 weeks,2 weeks,4 weeks after MI and RDN,the heart B-ultrasonography was measured respectively to determine LVESD,LVEDD and LVFS,LVEF,and to determine the effect of RDN on cardiac structure remodeling after myocardial infarction.Dynamic electrocardiogram was used to assess heart rate variability and to clarify the changes of sympathetic nerve activity in Preoperation and 1d,4w and 8w(4w after MI)after MI.Meanwhile,the levels of B-type natriuretic peptide(BNP)and angiotensin II(AngII)in blood were detected at the same time,and the influence of RDN on the factors of nerve fluid after myocardial infarction was clarified.Results: LVESD,LVEDD markly increased,LVEF and LVFS significantly narrowed after MI(P<0.05),Compared with the MI group,the LVESD and LVEDD were significantly reduced after 4 weeks of RDN,and LVFS and LVEF obviously increased(P<0.05).Levels of BNP and AngII increased gradually in 4 weeks after MI,and increased markedly in 4 weeks after myocardial infarction.At the same time,levels of BNP and AngII are lower in MI+RDN group than MI group(P<0.05),the difference was significant(P>0.05).In MI group,LF standardized value and LF/HF was decreased gradually after myocardial infarction,HF standardized value was increased.In the MI+RDN group,the value of LF normalized gradually increased,LF/HF gradually decreased,the difference was statistically significant(P<0.05).Conclusion: The renal denervation can reduce the incidence of heart failure after myocardial infarction by reducing the systemic sympathetic activity,it may be a new way for the treatment of heart failure.