4.5 Article

Effects of renal denervation on cardiac function after percutaneous coronary intervention in patients with acute myocardial infarction

Journal

HELIYON
Volume 9, Issue 7, Pages -

Publisher

CELL PRESS
DOI: 10.1016/j.heliyon.2023.e17591

Keywords

Acute myocardial infarction; Renal denervation; Sympathetic nervous system; Cardiac function; Arrhythmia

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The objective of this study was to observe the effect of renal artery denervation (RDN) on cardiac function in patients with acute myocardial infarction after percutaneous coronary intervention (AMI-PCI). A total of 108 AMI-PCI patients were randomly assigned to the RDN group or the control group. After 6 months of follow-up, the RDN group showed significantly improved left ventricular ejection fraction, cardiopulmonary exercise test indicators, and heart rate variability compared to the control group. The findings suggest that RDN intervention after PCI in AMI patients can improve cardiac function and exercise tolerance, possibly by inhibiting sympathetic nerve activity and restoring sympathetic-vagal balance.
Objective: To observe the effect of renal artery denervation (RDN) on cardiac function in patients with acute myocardial infarction after percutaneous coronary intervention (AMI-PCI). Methods: This is a single-centre, prospective randomized controlled study. A total of 108 AMI-PCI patients were randomly assigned to the RDN group or the control group at 1:1 ratio. All patients received standardized drug therapy after PCI, and patients in the RDN group underwent additional RDN at 4 weeks after the PCI. The follow-up period was 6 months after RDN. Echocardiography-derived parameters, cardiopulmonary exercise testing (CPET) data, Holter electrocardiogram, heart rate variability (HRV) at baseline and at the 6 months-follow up were analyzed. Results: Baseline indexes were similar between the two groups (all P > 0.05). After 6 months of follow-up, the echocardiography-derived left ventricular ejection fraction was significantly higher in the RDN group than those in the control group. Cardiopulmonary exercise test indicators VO2Max, metabolic equivalents were significantly higher in the RDN group than in the control group. HRV analysis showed that standard deviation of the normal-to-normal R-R intervals, levels of square root of the mean squared difference of successive RR intervals were significantly higher in the RDN group than those in the control group. Conclusions: RDN intervention after PCI in AMI patients is associated with improved cardiac function, improved exercise tolerance in AMI patients post PCI. The underlying mechanism of RDN induced beneficial effects may be related to the inhibition of sympathetic nerve activity and restoration of the sympathetic-vagal balance in these patients.

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