Renal denervation decreases susceptibility of the heart to ventricular fibrillation in a canine model of chronic kidney disease

Abstract

Renal denervation (RDN) has been shown to have therapeutic values in patients with chronic kidney disease (CKD). This study aimed to investigate whether RDN could decrease susceptibility of the heart to ventricular fibrillation in a canine model of CKD. Twenty-one dogs were included in this study. CKD was produced by subtotal nephrectomy in sixteen dogs with RDN treatment (CKD + RDN group, N = 8) or sham RDN (CKD group, N = 8). Another 5 dogs underwent sham operation and sham RDN to serve as controls (CTR group). Parameters of renal function, blood pressure, echocardiography, electrocardiogram, norepinephrine and inflammation were measured at baseline and 6 weeks after the surgical procedure. The ventricular fibrillation threshold (VFT) was determined at the end of study. Subtotal nephrectomy successfully induced a canine CKD model. When compared to CTR group, subtotal nephrectomy in CKD group significantly elevated blood pressure; increased the left ventricular mass, the end-diastolic left ventricular internal dimension, the left ventricular end-diastolic posterior wall thickness, the end-diastolic interventricular septum thickness; prolonged the intervals of QT, corrected QT, Tpeak to Tend (Tp-e), corrected Tp-e, and increased the QT dispersion and the Tp-e/QT ratio; decreased the VFT; increased the serum levels of norepinephrine, C reactive protein, and interleukin 6. However, RDN significantly attenuated these changes induced by CKD. The present study demonstrated that RDN could decrease susceptibility of the heart to ventricular fibrillation in this CKD model. Improvement of left ventricular hypertrophy, sympathetic activation, and inflammation by RDN may be responsible for its beneficial effects.

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