The effects and mechanism of radiofrequency ablation denervation at renal arterial intima on renal arterial endothelial function in pigs

2018 
Objective To study and evaluate the changes in endocrine function of renal arterial endothelial cells and possible mechanism on routinely temperature-controlled cardiac radiofrequency ablation catheter-based renal sympathic denervation in the acute phase. Methods 6 minipigs were performed bilateral renal artery angiography and radiofrequency ablation catheter-based unilateral renal sympathic denervation. Treated renal arteries served as operation group (n=6), and contralateral renal arteries untreated acted as sham-operation group (n=6). Pigs were examined for angiography again after the procedure and were euthanized immediately. Renal arteries were taken out and processed for histological, molecular biological analyzes to compare the changes of renal arterial structure and endothelial function in both groups. Results Compared to the sham-operation group, renal denervation caused renal arterial spasm, lacking immunostaining for von Willebrand Factor of endothelial cell, vacuolar degeneration of smooth muscle cells and adventitial axons, the decrease of gene expression (0.97±0.02 vs 0.61±0.08, 0.98±0.13 vs 0.35±0.02, all P<0.01) and the down-regulation of phosphorylation level (0.62±0.23 vs 0.12±0.04, 0.75±0.22 vs 0.29±0.17, all P<0.01) of protein kinase B-endothelial-nitric oxide synthase signaling pathway, the increase of gene expression (0.52±0.04 vs 0.82±0.10, P<0.01) and the up-regulation of protein expression (0.15±0.05 vs 0.34±0.08, P<0.01) of endothelin 1, the increase of gene expression (0.55±0.03 vs0.85±0.10, P<0.01) and the up-regulation of protein expression (0.13±0.04 vs 0.27±0.06, P<0.01) of endothelin A receptor. Conclusions In the swine model, renal sympathic denervation caused injury of renal arterial wall structure in an acute phase, which led to endocrine dysfunction of endothelial cells. The safety needed to be further assessed. Key words: Catheter ablation; Renal artery; Denervation
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