A comparison of the efficacy of surgical renal denervation and pharmacologic therapies in post-myocardial infarction heart failure.
OBJECTIVE
Although renal denervation (RD) has been shown to be effective in treating post- myocardial Infarction (MI) heart failure (HF) in animal models and clinical trials, its utility as a standalone treatment without traditional drug treatment for post-MI HF still needs to be investigated.


METHODS
Rats were randomly assigned into seven experimental groups: N group (control group with no MI and no RD, n = 10), MI group (MI, n = 20), RD group (renal denervation, n = 10), RD-3d+MI group (RD performed three days before MI, n = 15), β-blocker-3d+MI group (Metoprolol treated three days before MI, n = 15), ACEI-3d+MI group (Perindopril treated three days before MI, n = 15), and ARB-3d+MI group (Losartan treated three days before MI, n = 15). Cardiac function, autonomic nervous system parameters, and neuroendocrine activities were evaluated 8 weeks post MI.


RESULTS
Compared to β-blockers, ACEIs, and ARBs, RD alone provided significantly better cardiac remodeling and function, enhanced water and sodium excretion, and improved autonomic modulation.


CONCLUSIONS
In this post-MI HF animal model, surgical RD provides effective autonomic modulation, inhibition of the RAAS, improved cardiac remodeling, and preserved renal function, without affecting normal circulation and cardiopulmonary function in normal rats. Compared to β-blocker, ACEI, and ARB single-drug therapies, RD alone is more efficacious. These results suggest that RD may be an effective treatment option for HF, especially in patients who have contraindications to drug therapy.
Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China.
Jialu
J
Hu
Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China.
Yinliang
Y
Li
Department of Cardiology, Shanghai Jiaotong University affiliated Sixth People's Hospital South Campus, Shanghai, China.
Wenbo
W
Cheng
Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China.
Zhen
Z
Yang
Department of Cardiology, Shanghai Jiaotong University affiliated Sixth People's Hospital South Campus, Shanghai, China.
Fang
F
Wang
Department of Diagnostic Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.
Peng
P
Lv
Shanghai Medical College, Fudan University, Shanghai, China.
Conway
C
Niu
Department of Cardiology, Shanghai Jiaotong University affiliated Sixth People's Hospital South Campus, Shanghai, China.
Yuemei
Y
Hou
Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China.
Yan
Y
Yan
Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China.
Junbo
J
Ge
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000450:Aldosterone / Q000097:blood; D000804:Angiotensin II / Q000097:blood; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000818:Animals; D003714:Denervation; D004195:Disease Models, Animal; D016232:Endothelins / Q000097:blood; D006333:Heart Failure / Q000188:drug therapy* / Q000601:surgery*; D006339:Heart Rate; D006439:Hemodynamics; D007668:Kidney / Q000294:innervation* / Q000601:surgery*; D008297:Male; D009203:Myocardial Infarction / Q000150:complications* / Q000188:drug therapy; D020097:Natriuretic Peptide, Brain / Q000097:blood; D009638:Norepinephrine / Q000097:blood; D051381:Rats; D017208:Rats, Wistar; D012083:Renin / Q000097:blood; D016896:Treatment Outcome; D016277:Ventricular Function, Left
D000319:Adrenergic beta-Antagonists; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D016232:Endothelins; D000804:Angiotensin II; D020097:Natriuretic Peptide, Brain; D000450:Aldosterone; D012083:Renin; D009638:Norepinephrine