title: Improvement of cardiac dysfunction by bilateral surgical renal denervation in animals with diabetes induced by high fructose and high fat diet.
abstract: OBJECTIVE
  Insulin resistance (IR) and sympathetic over-activation play a critical role in diabetic cardiomyopathy (DCM). Percutaneous renal sympathetic denervation (RDN) was tested to treat refractory hypertension. However, the benefits of RDN for DCM and IR still remain unknown. The present study aimed to investigate the effect and associated mechanisms of bilateral surgical RDN (bsRDN) on cardiac function and glucose metabolism in animals with diabetes.
  
  
  METHODS
  Thirty-two male New Zealand white rabbits were randomly assigned to Chow (n=8, normal diet) and TEST (n=24, high-fructose fat diet [HFD]) groups. At 48 weeks after HFD feeding, animals in the TEST group were randomized to the Sham, HFD, and RDN subgroups and were fed a HFD for an additional 8 weeks. Repeated measurements of cardiac function, IR, apoptosis/autophagy, and histopathological assessment were performed at 48 and 56 weeks.
  
  
  RESULTS
  HFD feeding for 56 weeks induced IR and diastolic cardiac dysfunction with hypertrophy in septum but well preserved eject fraction in the animals. Impaired IR further deteriorated over the time in the RDN group, featured by a more profound reduction in GLUT4 mRNA and its translocation to the plasma membrane. Successful denervation was associated with improvement of cardiac function via preventing myocardial fibrosis and over-expression of procollagen III, mammalian target of rapamycin, and cardiac apoptosis. Cardiac autophagy, assessed by either electron microscopy or Western blot, was enhanced by bsRDN.
  
  
  CONCLUSIONS
  Renal sympathetic denervation led to a significant improvement of HFD-induced cardiac dysfunction by shifting the cardiac apoptosis to autophagy, but worsening IR. Further study is required to identify the clinical benefits of RDN.
authors.affiliation: Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, China.
authors.forename: YanRong
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Li
authors.affiliation: Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, China.
authors.forename: MingHui
authors.initials: M
authors.lastname: Li
authors.affiliation: Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, China.
authors.forename: YiHui
authors.initials: Y
authors.lastname: Yu
authors.affiliation: Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, China.
authors.forename: ZhiMei
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, China. Electronic address: chmengx@126.com.
authors.forename: ShaoLiang
authors.initials: S
authors.lastname: Chen
mesh_terms: D000818:Animals; D017209:Apoptosis; D001343:Autophagy; D003714:Denervation / Q000379:methods*; D003921:Diabetes Mellitus, Experimental / Q000150:complications*; D058065:Diabetic Cardiomyopathies / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D059305:Diet, High-Fat / Q000009:adverse effects; D004452:Echocardiography; D005632:Fructose / Q000633:toxicity; D006352:Heart Ventricles / Q000648:ultrastructure; D007668:Kidney / Q000294:innervation*; D008297:Male; D008854:Microscopy, Electron; D009206:Myocardium / Q000648:ultrastructure; D011817:Rabbits; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*
chemical_list: D005632:Fructose
keywords: Apoptosis; Autophagy; Bilateral surgical renal denervation; Diabetic cardiomyopathy; Insulin resistance