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肾去交感神经对心房神经节刺激诱发心房颤动的影响

Effect of renal sympathetic denervation on the inducibility of atrial fibrillation by anterior right ganglionic plexi stimulation

摘要:

目的 探讨经导管消融肾交感神经后对心房右前神经节(ARGP)刺激诱发心房颤动(房颤)的影响.方法 13只犬随机分为对照组(n=7)和消融组(n=6).对照组犬于右侧第4肋间开胸,采用不同电压高频刺激(20 Hz,0.1 ms) ARGP,观察心率减慢和房颤诱发情况;消融组犬先监测心房有效不应期(AERP),后行双侧经皮介入肾动脉消融,喂养6周后ARGP刺激同对照组.消融组犬在肾动脉消融前及后6周取静脉血检测血管紧张素Ⅱ(AngⅡ)及醛固酮水平.结果 消融组AERP在消融前及后6周差异无统计学意义[(134.4± 19.2) ms对(142.0±21.5) ms,P>0.05].与对照组相比,消融组犬ARGP刺激引起心率减慢50%所需电压[(3.5±1.6)V对(1.6±0.3)V,P=0.03]和诱发房颤的最低电压[(5.1±1.0)V对(2.1±0.7)V,P=0.03]明显升高.消融组犬消融6周后血清AngⅡ[(142.8±31.7) pg/ml对(91.7±23.8)pg/ml,P=0.01]和醛固酮水平[(272.2±37.4) pg/ml对(156.3±17.6)pg/ml,P<0.01]明显降低.结论 肾去交感神经可抑制ARGP刺激对房颤的诱发,其机制可能与肾去交感神经后肾素-血管紧张素-醛固酮系统活性降低有关.

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abstracts:

Objective To investigate the effect of renal sympathetic denervation on inducibility of atrial fibrillation(AF) by anterior right ganglionic plexi (ARGP)stimulation.Methods Thirteen dogs were used for the study as follows:control group(n =7) and renal artery ablation (RAA) group (n =6).In control group,after right thoracotomy,high-frequency electrical stimulation(20 Hz,0.1 ms duration)was applied to the ARGP for 1 minute by incremental voltages up to the voltage that induced AF.In RAA group,after atrial effective refractory period (AERP) measured,each renal artery was ablated and dogs were raised for 6 weeks.The procedure of ARGP stimulation was same as in the control group.Blood was collected before and after ablation 6 weeks to measure the levels ofangiotensin Ⅱ(Ang Ⅱ)and aldosterone(ALD) in RAA dogs.Results AERP had no significant change before and after renal artery ablation 6 weeks [(134.4±19.2) ms vs (142.0±21.5) ms,P>0.05].Compared with that in control group,dogs had higher voltage in the sinus rate slowing response induced by ARGP stimulation in RAA group[(3.5±1.6)V vs(1.6±0.3)V,P=0.03].Furthermore,the lowest voltage that induce AF was higher in RAA group than that in control group[(5.1±1.0)V vs(2.1±0.7)V,P=0.03].The plasma Ang Ⅱ and aldosterone concentration showed a greatly decreasing after RAA 6 weeks in RAA group [Ang Ⅱ:(142.8±31.7) pg/ml vs(91.7±23.8)pg/ml,P=0.01 ; Aldosterone:(272.2±37.4) pg/ml vs(156.3±17.6)pg/ml,P<0.01].Conclusions Renal sympathetic denervation inhibited the inducibility of AF during ARGP stimulation.This effect might have relationship with decreased activity of renin-angiotensin-aldosterone system(RAAS).

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作者: 于胜波 [1] 代子玄 [1] 邹明辉 [1] 王徐乐 [1] 肖金平 [1] 赵庆彦 [1] 黄从新 [1]
第一作者: 于胜波
栏目名称: 基础研究
DOI: 10.3760/cma.j.issn.1007-6638.2013.01.016
发布时间: 2013-04-26
基金项目:
国家自然科学基金
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