Effects of renal sympathetic denervation on the stellate ganglion and brain stem in dogs.

Abstract

BACKGROUND:

Renal sympathetic denervation (RD) is a promising method of neuromodulation for the management of cardiac arrhythmia.

OBJECTIVE:

We tested the hypothesis that RD is antiarrhythmic in ambulatory dogs because it reduces the stellate ganglion nerve activity (SGNA) by remodeling the stellate ganglion (SG) and brain stem.

METHODS:

We implanted a radiotransmitter to record SGNA and electrocardiogram in 9 ambulatory dogs for 2 weeks, followed by a second surgery for RD and 2 months SGNA recording. Cell death was probed by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay.

RESULTS:

Integrated SGNA at baseline and 1 and 2 months after RD were 14.0 ± 4.0, 9.3 ± 2.8, and 9.6 ± 2.0 μV, respectively (P = .042). The SG from RD but not normal control dogs (n = 5) showed confluent damage. An average of 41% ± 10% and 40% ± 16% of ganglion cells in the left and right SG, respectively, were TUNEL positive in RD dogs compared with 0% in controls dogs (P = .005 for both). The left and right SG from RD dogs had more tyrosine hydroxylase-negative ganglion cells than did the left SG of control dogs (P = .028 and P = .047, respectively). Extensive TUNEL-positive neurons and glial cells were also noted in the medulla, associated with strongly positive glial fibrillary acidic protein staining. The distribution was heterogeneous, with more cell death in the medial than lateral aspects of the medulla.

CONCLUSION:

Bilateral RD caused significant central and peripheral sympathetic nerve remodeling and reduced SGNA in ambulatory dogs. These findings may in part explain the antiarrhythmic effects of RD.

• Authors: Wei-Chung Tsai, Yi-Hsin Chan, Kroekkiat Chinda, Zhenhui Chen, Jheel Patel, Changyu Shen, Ye Zhao, Zhaolei Jiang, Yuan Yuan, Michael Ye, Lan S Chen, Amanda A Riley, Scott A Persohn, Paul R Territo, Thomas H Everett, Shien-Fong Lin, Harry V Vinters, Michael C Fishbein, Peng-Sheng Chen
• Journal: Heart rhythm (Heart Rhythm) Vol. 14 Issue 2 Pg. 255-262 (02 2017) ISSN: 1556-3871 [Electronic] United States
• PMID: 27720832 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2016 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Topics

• Animals
• Arrhythmias, Cardiac (surgery)
• Brain Stem (physiopathology)
• Dogs
• Heart Rate
• Kidney (innervation)
• Neuronal Plasticity
• Neurophysiological Monitoring (methods)
• Stellate Ganglion (physiopathology)
• Sympathectomy (adverse effects, methods)
• Sympathetic Nervous System (surgery)
• Treatment Outcome