Effect of Renal Denervation on Suppression of PVC and QT Prolongation in a Porcine Model of Acute Myocardial Infarction

BACKGROUND AND OBJECTIVES: Antiarrhythmic effect of renal denervation (RDN) after acute myocardial infarction (AMI) remains unclear. The goal of this study was to evaluate the effect of RDN on ventricular arrhythmia (VA) after AMI in a porcine model.METHODS: Twenty pigs were randomly divided into 2 groups based on RDN (RDN, n=10; Sham, n=10). After implanting a loop recorder, AMI was induced by occlusion of the middle left anterior descending coronary artery. Catheter-based RDN was performed for each renal artery immediately after creating AMI. Sham procedure used the same method, but a radiofrequency current was not delivered. Electrocardiography was monitored for 1 hour to observe VA. One week later, the animals were euthanized and the loop recorder data were analyzed.RESULTS: Ventricular fibrillation event rate and the interval from AMI creation to first VA in acute phase were not different between the 2 groups. However, the incidence of premature ventricular complex (PVC) was lower in the RDN than in the Sham. Additionally, RDN inhibited prolongation of the corrected QT (QTc) interval after AMI. The frequency of non-sustained or sustained ventricular tachycardia, arrhythmic death was lower in the RDN group in the early period.CONCLUSIONS: RDN reduced the incidence of PVC, inhibited prolongation of the QTc interval, and reduced VA in the early period following an AMI. These results suggest that RDN might be a therapeutic option in patients with electrical instability after AMI.

Ross Syndrome with Segmental Anhidrosis and Anisocoria: Application of Finger Winkle Test

Ross syndrome is characterized by a triad of segmental anhidrosis, tonic pupil, and generalized areflexia. Selective postganglionic autonomic denervation could be the differential diagnostic point for other diseases of the autonomic nervous system. Here we report a patient with regional anhidrosis in his left hand and sole, and anisocoria. An evaluation of sweating and the pupillary response together with generalized areflexia confirmed the diagnosis of Ross syndrome. The finger wrinkle test is a simple and useful tool for revealing segmental sympathetic denervation.

Avaliação dos efeitos da variabilidade da pressão arterial sistêmica sobre a pressão de perfusão ocular e suas repercussões sobre o estresse oxidativo em retinas de ratos normotensos e hipertensos / Assessment of the effects of the variability of blood pressure on the ocular perfusion pressure and its effects on oxidative stress in normotensive and hypertensive rats

Introdução: A hipertensão arterial sistêmica (HAS) é uma doença que pode determinar lesões em diversos órgãos inclusive nos olhos. As doenças vasculares oculares constituem a grande maioria das causas de cegueira na atualidade e a HAS tem contribuição importante nesta estatística. A variabilidade da pressão arterial tem sido implicada na gênese de uma série de lesões de órgãos-alvo. Na tentativa de compreender melhor a patogênese das doenças vasculares oculares testamos a hipótese de que não apenas os efeitos da HAS, mas também a variabilidade da pressão arterial (PA) poderia determinar lesão de órgão-alvo (ocular). Materiais e Métodos: A desnervação sino-aórtica (DSA), um modelo experimental de aumento da variabilidade da pressão arterial foi utilizado nos experimentos. Foram obtidas medidas da pressão intraocular e a partir destas medidas, a pressão de perfusão ocular. Foram analisados marcadores de estresse oxidativo (8-OHdG e nitrotirosina),VEGF e receptores AT1 na retina de animais normotensos e hipertensos com e sem DSA aguda (12 e 24 horas) e crônica (10 semanas). Resultados: Os animais desnervados apresentaram aumento da variabilidade da PA sem modificar a PA basal e redução da sensibilidade do barorreflexo. Houve aumento da modulação simpática vascular e da pressão de perfusão ocular (PPO), nos animais hipertensos, com aumento adicional da PPO nos hipertensos e desnervados crônicos.Observou-seestresse oxidativo retiniano nos animais desnervados agudos e noshipertensos desnervados crônicos, além do aumento da expressão de receptores AT1 da Angiotensina II nos animais hipertensos. Os níveis de VEGF retinianos dos animais desnervados crônicos, apresentaram comportamento inverso aos níveis de Caspase-3. Conclusão: Tais resultados indicam que só a HAS, mas também a variabilidade da PA podem determinar variações na pressão de perfusão ocular, assim como também podem induzir dano oxidativo às células retinianas. Além disso, pode-se sugerir efeito...

Introduction: High blood pressure (HBP) is a disease that can determine lesions in many organs including the eyes. The ocular vascular diseases constitute the vast majority of causes of blindness and hypertension has important contribution in this statistic. Blood pressure variability has been implicated in the genesis of a series of end-organ damage. In an attempt to better understand the pathogenesis of ocular vascular diseases, we hypothesized that not only the effects of hypertension, but also the variability of blood pressure (BPV) could determine target end-organ damage (ocular). Materials and Methods: Sino-aortic denervation (SAD), an experimental model of increased blood pressure variability was used in the experiments. The intraocular pressure measurements were performed and from these measurements the ocular perfusion pressure was estimated. Oxidative stress markers (8-OHdG and nitrotyrosine), VEGF and AT1 receptor in rat retinas were analyzed inacute and chronic hypertensive and normotensiveSAD rats and in controls. Results: Denervated animals showed increased BP variability without altering the basal BP, while presenting reduced baroreflex sensitivity.There was an increase in sympatheticvascular modulation and in OPP,in hypertensive animals, that was additionally in chronic denervated hypertensive animals.Acute denervated and chronic hypertensive denervated animals showed retinal oxidative stress as well as hypertensive animals presented increased expression of AT1 receptors of angiotensin II. The levels of retinal VEGF of chronically denervated animals showed inverse behavior of levels of Caspase-3 Conclusion: These results suggest that, apart from the arterial hypertension, BP variability not only determines changes in ocular perfusion pressure, but also induces oxidative damage to retinal cells. Furthermore, one can suggest retinal neuroprotective effect of VEGF...

Influência da desnervação seletiva dos barorreceptores e quimiorreceptores nas variáveis hemodinâmicas e morfofuncionais dos tecidos cardíaco e músculo-esquelético em ratos espontaneamante hipertensos / Influence of selective denervation of baroreceptors and chemoreceptors in hemodynamic variables and tissue morphofunctional cardiac and musculoskeletal in spontaneously hypertensive rats

A hipertensão arterial (HA) é uma doença multifatorial na qual há a interação de vários mecanismos, e está relacionada com alterações funcionais e/ou estruturais dos órgãos-alvo. Alterações funcionais dos mecanismos regulatórios da pressão arterial (PA) a curto prazo, como os barorreceptores e os quimiorreceptores, vem sendo bastante exploradas com o objetivo de entender os possíveis mecanismos que podem estar relacionadas à gênese da HA. Diante disso, utilizamos o modelo experimental de desnervação sinoaórtica (DSA) e desnervação seletiva desses aferentes (aórtica DA) e/ou carotídea (DC) e a ligadura da artéria do corpúsculo carotídeo (LA) para avaliarmos a importância relativa dos barorreceptores e quimioreceptores no controle neurogênico da circulação mediando respostas cardíacas e músculo-esqueléticas na HA. Para tanto, utilizamos ratos Wistar (CTR) e espontaneamente hipertensos (SHR) submetidos às diferentes desnervações (SHRDSA/ SHRDA / SHRDC), bem como, a ligadura da artéria do corpúsculo carotídeo (SHRLA). Os animais foram acompanhados durante 10 semanas após as desnervações seletivas, e em seguida foram realizadas as avaliações ecocardiográficas, gasometria arterial, hemodinâmicas, autonômicas e de fluxo sanguíneo regional. Posteriormente, os animais foram eutanasiados para a coleta dos tecidos para as avaliações gênicas e histológicas. Resultados: Os animais SHR apresentaram disfunções hemodinâmicas, autonômicas e gasométricas (alcalose respiratória) quando comparado ao grupo CTR, assim como nas análises de hipertrofia, fluxo e histologia do músculo esquelético, como transição no fenótipo para um perfil mais glicolítico no sóleo e aumento da área de secção transversa das fibras do tipo I e redução das fibras do tipo IIB no músculo diafragma. Nos grupos experimentais hipertensos, os animais com prejuízo do quimiorreflexo (SHRDC, SHRLA e SHRDSA), apresentaram valores maiores de pCO2 em relação ao grupo SHR e SHRDA...

Arterial hypertension (AH) is a multifactorial disease on which there is the interaction of several mechanisms , therefore is related to functional and / or structural changes of the target organ . Functional changes of the regulatory mechanisms of blood pressure (BP) in the short term , as pressoreceptor and chemoreceptors, has been extensively explored in order to understand the possible mechanisms that may be related to the genesis of hypertension. Thus, we used the experimental model of sinoaortic denervation (DSA) and selective denervation of those afferent aortic (DA) and / or carotid (DC) and the ligature of the carotid body artery (LA) to evaluate the relative importance of baroreceptors and chemoreceptors on control of neurogenic circulation mediating cardiac and musculoskeletal responses in HA. There by, we used Wistar rats (CTR) and spontaneously hypertensive rats (SHR) subjected to different denervation (SHRDSA / SHRDA / SHRDC) and the ligature of the carotid body artery (SHRLA). The animals were followed for 10 weeks after the selective denervation it was performed echocardiographic evaluations, blood gas, hemodynamic, autonomic and regional blood flow. Subsequently, the animals were euthanized for tissue collection for genetic and histological evaluations. Results: SHR animals showed hemodynamic, autonomic dysfunction and gas exchange (respiratory alkalosis) compared to CTR group as well as the analysis of hypertrophy, flow and histology of skeletal muscle, such as the transition to a more glycolytic phenotype profile in soleus and increased cross-sectional area of type I fibers and reduction of type IIB fibers in the diaphragm . In hypertensive experimental groups, animals with prejudice chemoreflex (SHRDC, SHRLA and SHRDSA) , showed higher pCO2 compared to SHR and SHRDA group. All groups with different denervation showed autonomic changes in blood flow and capillarization. However, our major findings were compared to SHRDA group...

Avaliação da função ventricular sistólica e diastólica pelo ecocardiograma transesofágico e da capacidade funcional em ratos espontaneamente hipertensos submetidos à desnervação sino-aórtica / Evaluation of the systolic and diastolic ventricular function by transesophageal echocardiogram and functional capacity in spontaneously hypertensive rats submitted to sinoaortic denervation

INTRODUÇÂO: Durante o desenvolvimento da hipertensão arterial sistêmica (HAS) ocorre a hiperatividade simpática, que está relacionada ao comprometimento dos sistemas baro e quimiorreflexo arteriais e disfunção ventricular esquerda (VE). Entretanto, a função ventricular direita (VD) tem sido pouco avaliada no contexto da HAS associada à desnervação sino-aórtica (DSA). OBJETIVO: Avaliar a função biventricular de forma não-invasiva e invasiva, a capacidade funcional, a sensibilidade barorreflexa e o controle autonômico cardiovascular em ratos Wistar (W) e ratos espontaneamente hipertensos (SHR) submetidos ou não à DSA. MÉTODOS: Após 10 semanas de DSA, a função cardíaca foi avaliada pelo teste de esforço (TE), ecocardiograma transtorácico e transesofágico, e a pressão diastólica final biventricular; as funções hemodinâmica e autonômica foram avaliadas pelo registro da pressão arterial (PA) e da freqüência cardíaca (FC), variabilidade da PA e da FC e sensibilidade barorreflexa. Os ratos (n = 32) foram divididos em 4 grupos: 16 W com (n = 8) e sem DSA (n = 8), 16 SHR com (n = 8) ou sem DSA (n = 8). RESULTADOS: A PA e a FC não apresentaram alterações entre os grupos DSA e não-DSA, entretanto, os SHR apresentaram níveis mais elevados da PA comparado com W. O TE mostrou que os SHR apresentaram melhor capacidade funcional em relação ao DSA e SHRDSA (W: 1,16±0,3m/s, DSA: 0,9±0,15m/s, *SHR: 1,46±0,29m/s, SHR-DSA: 1,02±0,31, *p< 0,05 vs. DSA e SHRDSA). Os SHRs apresentaram aumento da variabilidade da PA comparados aos W. Após a DSA houve aumento da variabilidade PA em todos os grupos comparados ao W (W: 15±29 mmHg2, *DSA: 49±27 mmHg2, *SHR: 60±29 mmHg2, *SHR-DSA: 137±76 mmHg2, *p<0,05 vs. W). Foi observado hipertrofia concêntrica do VE; disfunção sistólica segmentar e diastólica global do VE...

INTRODUCTION: During the development of hypertension, sympathetic hyperactivity commonly seems to be related to the left ventricular (LV) dysfunction and baro and chemoreflexes impairment. However, right ventricle (RV) function has not been evaluated specially regarding the association of hypertension and baroreflex dysfunction. OBJECTIVE: To evaluate noninvasively and invasively the biventricular myocardial function, the functional capacity, the baroreflex sensitivity and the cardiovascular autonomic control in Wistar (W) rats and spontaneously hypertensive rats (SHR) submitted or not to sinoaortic denervation (SAD). METHODS: Ten weeks after DSA, cardiac function was evaluated by the maximal exercise test (MET), by transthoracic (TT) and transesophageal echocardiography (TEE) and the biventricular end diastolic pressures (EDP). Additionally, hemodynamic and autonomic functions were evaluated by the blood pressure (BP) and heart rate (HR) records, BP and HR variability and baroreflex sensitivity. The rats (n=32) were divided in 4 groups: 16 Wistar (W) with (n=8) or without SAD (n=8) and 16 SHR, with (n=8) or without SAD (n=8). RESULTS: Blood pressure and HR did not show any change between the groups SAD and without SAD, although, SHR showed higher BP levels in comparison to W. MET results showed that SHR had better functional capacity compared to SAD and SHRSAD (W: 1,16±0,3m/s, DSA: 0,9±0,15m/s, *SHR: 1,46±0,29m/s, SHR-DSA: 1,02±0,31, *p< 0.05 vs. SAD and SHRSAD). BP variability was increased in SHR groups compared to W. After SAD, BP variability increased in all groups compared to W (W: 15±29 mmHg2, *DSA: 49±27 mmHg2, *SHR: 60±29 mmHg2, *SHR-DSA: 137±76 mmHg2, *p<0.05 vs. W)...

Chronic effect of vagotomy in the morphometry of the myenteric plexus of rats' duodenum / Efeito crônico da vagotomia sobre a morfometria do plexo mioentérico do duodeno de ratos

BACKGROUND: The gastrointestinal disorders have been associated with morphological alterations in the myenteric nervous plexus. AIM: To evaluate, through morphometric studies, the chronic effects of the subdiaphragmatic trunk vagotomy on the nervous plexus. METHODS: Fifteen male exemplars of Wistar Rattus novergicus weighing about 150g, distributed into three groups, have been used: control (n=5), Sham (n=5) and vagotomized (n=5). The animals were sacrificed after 30 and 90 days post surgery. Fragments of duodenum were fixed in Bouin solution, embedded into paraffin and stained with HE and PAS. Morphometric analysis was performed by a Carl Zeiss KM 450 image system. The following aspects were observed: the density of nervous cells per linear micrometer (µm) (ND); the area of perikarya (µm²) (NA); the number of satellite cells per µm (SCD); and the number of satellite cells per neuron (SC/N). The averages were compared with the help of "software" program Sigma Plus through two way - ANOVA and Tuckey post-test. RESULTS: Denervation increased SC/N (p<0,05) and NA (p<0,05), in a time-dependent denervation way (p<0,05). However ND and SCD, decreased, which significantly with the animal's age (p<0,001). CONCLUSION: Vagotomy altered the myenteric plexus morphology in a time-dependent way.

RACIONAL: As disfunções gastrintestinais têm sido associadas à alterações morfológicas no plexo nervoso mioentérico. OBJETIVO: Avaliar através do estudo morfométrico, os efeitos crônicos da vagotomia troncular subdiafragmática sobre esse plexo nervoso. MÉTODOS: Foram utilizados 15 exemplares machos de Rattus novergicus da variedade Wistar, com cerca de 150 g, distribuídos nos grupos controle (n=5), Sham (n=5) e vagotomizados (n=5). Os animais foram sacrificados depois de 30 e 90 dias após as operações. Em seguida, fragmentos do duodeno foram fixados em solução de Bouin, incluídos em parafina e corados por HE e PAS. A análise morfométrica foi realizada por meio do sistema de análise de imagem Carl Zeiss KM 450. Foram observados: a densidade de células nervosas por micrômetro linear (µm); a área dos pericários (µm²); o número de células satélites por µm; e o número de células satélites por neurônio. As médias foram comparadas com o auxílio do programa de "software" Sigma Plus através do Two way - ANOVA e do pós-teste de Tukey. RESULTADOS: A desnervação aumentou o número de células satélites por neurônios (p<0,05) e a área média dos pericários (p<0,05), de maneira dependente do tempo de desnervação (p<0,05), mas diminuiu significativamente a densidade de neurônios (p<0,05) e de células satélites (p<0,05) em função da idade (p<0,001). CONCLUSÃO: A vagotomia alterou a morfologia do plexo mioentérico de maneira dependente do tempo.

Histological modifications of the rat prostate following transection of somatic and autonomic nerves

It is known that hormones influence significantly the prostate tissue. However, we reported that mating induces an increase in androgen receptors, revealing a neural influence on the gland. These data suggested that somatic afferents (scrotal and genitofemoral nerves) and autonomic efferents (pelvic and hypogastric nerves) could regulate the structure of the prostate. Here we assessed the role of these nerves in maintaining the histology of the gland. Hence, afferent or efferent nerves of male rats were transected. Then, the ventral and dorsolateral regions of the prostate were processed for histology. Results showed that afferent transection affects prostate histology. The alveoli area decreased and increased in the ventral and dorsolateral prostate, respectively. The epithelial cell height increased in both regions. Efferent denervation produced dramatic changes in the prostate gland. The tissue lost its configuration, and the epithelium became scattered and almost vanished. Thus, afferent nerves are responsible for spinal processes pertaining to the trophic control of the prostate, activating its autonomic innervation. Hence, our data imply that innervation seems to be synergic with hormones for the healthy maintenance of the prostate. Thus, it is suggested that some prostate pathologies could be due to the failure of the autonomic neural pathways regulating the gland.

Sabe-se que os hormônios influenciam significativamente o tecido prostático. Entretanto, nós demonstramos que o acasalamento induz um aumento nos receptores androgênicos, revelando uma influência neural sobre a glândula. Esses dados sugerem que os aferentes somáticos (nervos escrotal e genito-femural) e os eferentes autonômicos (nervos pélvicos e hipo-gástricos) poderiam regular a estrutura da próstata. Neste trabalho, avaliou-se a função destes nervos na manutenção da histologia da glândula. Dessa forma, os nervos aferentes e eferentes de ratos machos foram seccionados As regiões ventral e dorsolateral da próstata foram processadas para histologia. Os resultados mostraram que a transecção aferente afeta a histologia da próstata. A área alveolar diminuiu e aumentou na próstata dorsal e dorsolateral, respectivamente. A altura da célula epitelial aumentou em ambas as regiões. A desenervação eferente produziu alterações dramáticas na glândula prostática. O tecido perdeu a sua configuração e o epitélio tornou-se difuso e quase desapareceu. Assim, os nervos aferentes são responsáveis por processos espinhais que pertencem ao controle trófico da próstata, ativando sua inervação autonômica. Dessa forma, nossos dados sugerem que a inervação parece ser sinérgica com os hormônios para a manutenção saudável da próstata. Assim, sugere-se que algumas patologias prostáticas poderiam ser ocasionadas devido a falhas nas vias neurais autonômicas que regulam esta glândula.

Short-Term Autonomic Denervation of the Atria Using Botulinum Toxin

BACKGROUND AND OBJECTIVES: Major epicardial fat pads contain cardiac ganglionated plexi (GP) of the autonomic nervous system. Autonomic denervation may improve the success rate of atrial fibrillation (AF) ablation. This study was designed to elucidate the acute effects of blocking the right atrium-pulmonary vein (RA-PV) and left atrium-inferior vena cava (LA-IVC) fat pads on the electrophysiologic characteristics of the atrium and AF inducibility with a botulinum toxin injection. Materials and Methods: Eight mongrel dogs were studied. The RA-PV and LA-IVC fat pads were exposed through a median thoracotomy. Botulinum toxin (BT, 50 U to each fat pad, n=6) or normal saline (NS, n=2) was injected in the entire area of two fat pads. The study protocol was applied before injection and repeated at 1, 2, 3, 4, and 5 hours thereafter. The sinus rate, ventricular rate during rapid atrial pacing with a cycle length of 50 ms, and AF inducibility were measured with and without vagal stimulation (VS). Bilateral cervical VS was applied (20 Hz, 0.2 ms, 5.6+/-2.0 V). AF inducibility was evaluated with burst pacing with 200 impulses at a 50-ms cycle length. RESULTS: VS effects on the sinus node and AF inducibility were eliminated a few hours after injection of BT; these changes were not observed after injection of NS. CONCLUSION: Short-term autonomic denervation of the atria was achieved by blocking the major epicardial GP with BT.

Evidence that blood pressure remains under the control of arterial baroreceptors in renal hypertensive rats

The purpose of the present study was to determine the range of the influence of the baroreflex on blood pressure in chronic renal hypertensive rats. Supramaximal electrical stimulation of the aortic depressor nerve and section of the baroreceptor nerves (sinoaortic denervation) were used to obtain a global analysis of the baroreceptor-sympathetic reflex in normotensive control and in chronic (2 months) 1-kidney, 1-clip hypertensive rats. The fall in blood pressure produced by electrical baroreceptor stimulation was greater in renal hypertensive rats than in normotensive controls (right nerve: -47 ± 8 vs -23 ± 4 mmHg; left nerve: -51 ± 7 vs -30 ± 4 mmHg; and both right and left nerves: -50 ± 8 vs -30 ± 4 mmHg; P < 0.05). Furthermore, the increase in blood pressure level produced by baroreceptor denervation in chronic renal hypertensive rats was similar to that observed in control animals 2-5 h (control: 163 ± 5 vs 121 ± 1 mmHg; 1K-1C: 203 ± 7 vs 170 ± 5 mmHg; P < 0.05) and 24 h (control: 149 ± 3 vs 121 ± 1 mmHg; 1K-1C: 198 ± 8 vs 170 ± 5 mmHg; P < 0.05) after sinoaortic denervation. Taken together, these data indicate that the central and peripheral components of the baroreflex are acting efficiently at higher arterial pressure in renal hypertensive rats when the aortic nerve is maximally stimulated or the activity is abolished.

Apoptosis in rat corpus cavernous penis after neruotomy of bilateral dorsal nerve of penis and/or cavernous nerve / 法医学杂志

OBJECTIVE@#To observe the apoptosis in penile corpus cavernous after neurotomy.@*METHODS@#After neurotomy, 78 SD rats were randomly assigned to experimental and normal control groups at day 1, 2, 4, 8, 16, and 32 time point. The quality was measured by DNA Ladder and the quantitation was measured by TUNEL. The location of apoptosis was detected by dual stained with immunohistochemistry and TUNEL.@*RESULTS@#After transaction of cavernous nerve, dorsal never, and both nerves, the apoptosis in experimental and control group showed a statistically significant difference (P<0.0046); however there was no statistically significant difference after bilateral dorsal nerve transaction alone (P>0.0046). There was a statistically significant difference in apoptosis between cavernous smooth muscle cell and endothelial cell groups (P<0.05).@*CONCLUSION@#Cavernous nerve transection induces apoptosis in smooth muscle cells of the rat penis, but nor does dorsal nerve transaction alone. There is no statistically significant difference in apoptosis between cavernous nerve injury alone and combination injuries of cavernous nerve and dorsal nerve.

Chronic effects of percutaneous transmyocardial laser revascularization in patients with refractory angina / 中华心血管病杂志

<p><b>OBJECTIVE</b>Conflicting results exist on the therapeutic effects of percutaneous myocardial laser revascularization (PMR) in patients with refractory angina pectoris. This study assessed the effects of PMR on myocardial innervation and perfusion in patients with refractory angina pectoris.</p><p><b>METHODS</b>Patients with refractory angina unsuitable for standard revascularization treatment (PTI and CABG) were randomly divided into medication plus PMR (PMR, n = 17) and medication group (M, n = 13). Coronary sinus noradrenaline (NE) and epinephrine (E) levels, heart rate variability (HRV), total ischemic burden (TIB), and ischemic ST segmental events (STI), myocardial perfusion were evaluated at pre-, immediately post and 12 months post treatment (mean followed up time = 11.6 +/- 4.9 months).</p><p><b>RESULTS</b>In PMR group, one patient developed non-persistent ventricular tachycardia, 2 developed pericardial tamponade and another one patient developed heart failure at 24 h after operation. Coronary sinus NE and E were significantly lower 60 min post PMR compared to pre-PMR and HRV was significantly increased 24 h post PMR. One year post treatments, angina grade was significantly decreased in PMR (1.7 +/- 0.3) than that in M group (0.4 +/- 0.2, P < 0.05) while other parameters were similar between the groups.</p><p><b>CONCLUSIONS</b>PMR induced an early transient denervation and decreased angina grade one year post treatment in patients with refractory angina.</p>

Effects on erectile function of transplanted major pelvic ganglion into the corpus cavernosum of adult rats with bilateral cavernous nerve injury / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the effects on erectile function of transplanted major pelvic ganglion into the corpus cavernosum of adult male rats undergoing transection of bilateral cavernous nerves.</p><p><b>METHODS</b>Twenty-six male Sprague-Dawley rats (3 - 4 month-old and 300 - 400 g/each) were divided into 2 groups: experimental group (transection of bilateral cavernous nerves and transplantation of left ganglion into left crus of penis, n = 16) and control group (transection of bilateral cavernous nerves only, n = 10). Erectile function was measured by injecting APO, and intracavernous pressure was measured 1 and 3 months afterwards by electric-stimulating the right major pelvic ganglion or the left crus. Half animals in each group were sacrificed 1 and 3 months afterwards for detecting nNOS-containing nerve fibers of corpus cavernosum. Electron microscopy of the implanted area was performed to assess neuronal survival.</p><p><b>RESULTS</b>Both of the two groups have no erectile response to APO injection. Electrostimulation on the right major pelvic ganglion and left crus failed to produce erection in experimental group. The mean pressure changes in the two groups, measured by stimulating the left crus, were (9.41 +/- 3.20) and (4.16 +/- 2.58) cmH(2)O 1 month afterwards, and (13.67 +/- 4.18) and (5.09 +/- 2.74) cmH(2)O 3 months afterwards, respectively (P < 0.05). An increased number of nNOS-containing nerve fibers in left crus was detected in experimental group 1 and 3 months later, compared with control one (218.7 +/- 24.5, 18.0 +/- 3.7; 183.2 +/- 19.7, 19.0 +/- 3.8; P < 0.05). Ultrastructure examination by transmission electron microscope confirmed the survival of the implanted ganglion.</p><p><b>CONCLUSION</b>Major pelvic ganglion can survive in the corpus cavernosum, and it has significant effects on the number of nNOS-containing nerve fibers and the alteration of intracavernous pressure.</p>

Angiotensin II contents in plasma, and cardiac and renal tissues of sinoaortic denervated rats / 生理学报

Our previous data demonstrate that impairment of arterial baroreceptor reflex (ABR) plays an independent role in hypertension target organ damage. To elucidate the mechanisms responsible for the dysfunction of ABR associated organ damage, sinoaortic denervated (SAD) rats were used as an animal model of ABR dysfunction. Twenty-four-hour continuous blood pressure (SBP and DBP), blood pressure variability (BPV), heart rate (HR) and HR variability (HRV) were measured in conscious and unrestrained rats. Angiotensin II (Ang II) in plasma, heart and kidney was assayed by raio-immunological assay (RIA) 1 or 18 weeks after denervation. In short-term SAD rats, twenty-four-hour mean SBP and DBP increased compared with that of sham-operated rats and long-term SAD rats. No significant difference in SBP, DBP or HR was found between long-term SAD rats and sham-operated ones. Compared with the sham-operated rats, long-term SAD rats had elevated BPV. No significant change in Ang II levels of caridiac and renal tissues was found in short-term SAD rats. In long-term SAD rats, Ang II level of plasma was not increased while the Ang II content in the heart and kidney increased. Ang II contents of plasma and tissues in long-term SAD rats exposed to chronic stress were higher than those in the control rats. These results show (1) in short-term SAD rats blood pressure increased, while in long-term SAD rats 24 h mean blood pressure did not increase, although BPV elevated in long-term SAD rats; (2) in long-term SAD rats, secretion of Ang II in cardiac and renal tissues was enhanced and more Ang II released when the animals were exposed to chronic stress. These results suggest that elevated BPV and secretion of Ang II may be related to the development of organ damage induced by ABR dysfunction.

Evaluation of cardiac denervation in patients with long-standing diabetes

Evaluation of cardiac autonomic dysfunction in long-standing diabetics, comparing patients treated with insulin and oral hypoglycemic agents. Design: Observational and comparative study between two treatment groups. Place and Duration of Study: At Department of Medicine, Pakistan Institute of Medical Sciences, Islamabad, for 6 months. Subjects and Fifty diabetic patients of about 10 years illness were studied. Patients were divided into two groups, Group I [13 males, 12 females; mean age 33.08 years] included those who received insulin, and Group II patients [12 males, 13 females; mean age 54.68 years] who received oral hypoglycemic agents for their diabetic illness. Evaluation of cardiac denervation in both the groups was done in terms of presence of resting tachycardia, loss of sinus arrhythmia and abnormalities of Valsalva response. At least some form of cardiac denervation was present in 62% of total subjects. 48% of Group I and 76% of Group II patients. Asignificantly high number of patients treated with oral hypoglycemic agents had evidence of cardiac denervation when compared with patients who were treated with insulin [p < 0.05]. Cardiac denervation is common in long-standing diabetics specifically in those treated with oral hypoglycemic agents

The Effects of Autonomic Denervation on Ventricular Tachyarrhythmia in the Ischemia and the Reperfusion of Canine Heart

BACKGROUND: little is known about the mechanisms responsible for ventricular tachycardia during myocardial ischemia and reperfusion. The purpose of this study was to evaluate the effects of the autonomic nervous system on ventricular tachycardia in dogs. METHODS: Four groups of eight dogs were studied. The control group had intact autonomic neural innervation:the stellectomy group had bilateral transection of stellate ganglia:the vagotomy group had bilateral transection of cervical vagi; and the autonomic denervation group underwent bilateral transection of stellate ganglia and cervical vagi. Open-chest dogs anesthetized with ketamine were studied in 3 sequential steps: denervation, ischemia, and reperfusion stage. At the end of each step, we estimated effective refractory period (ERP) at four sites : the apex of non-ischemic area, the base of non-ischemic area, the apex of ischemic area, and the base of ischemic area. We observed early afterdepolarization (EAD) through recording monophasic action potential on the ischemic epicardium during ischemia and reperfusion stages. RESULTS: In ischemia stage, deltaERPs(ERPmax.-ERPmin.) were significantly prolonged, compared to deltaERPs at denervation stage, and deltaERPs of the vagotomy group tended to be prolonged to 60 minutes after myocardial ischemia, as compared to those of the stellectomy group and the autonomic denervation group. The incidence of ventricular tachycardia during ischemia presented a significant increase in the vagotomy group, compared to the control group. However, there was no difference in incidence of ventricular tachycardia between the stellectomy group and the control group. deltaERP at the group with the occurrence of ventricular tachycardia were significantly prolonged , compared to the other group without the occurrence of ventricular tachycardia. In terms of the incidence of EAD, there was no difference between the groups and it was not associated with ventricular tachycardia. deltaERP was significantly decreased to 30 minutes after reperfusion, at which point there was no significant difference between the groups. There was no correlation between EAD and ventricular tachycardia. However, deltaERP with ventricular tachycardia indicated much more significant increase than deltaERP without ventricular tachycardia. CONCLUSIONS: Sympathetic nerve may be related to prolongation of deltaERP and incidence of ventricular tachycardia in the ischemic period. However, EAD is not related to ventricular tachycardia during ischemia and reperfusion. These findings suggest that the major mechanism of ventricular tachycardia may be a reentry in ischemia and reperfusion period.

Fibrinógeno y lípidos en estados disautonómicos cardiovasculares en DMNID / Fibrinogen al lipids in cardiovascular disautonomy in NIDM

La enfermedad isquémica aterosclerótica cardiovascular ocupa los primeros lugares de morbimortalidad general, y es causa principal de mortalidad en pacientes con diabetes mellitus no insulino dependiente (DMNID). Trastornos en la microcirculación favorecen los estados disautonómicos cardiovasculares, que potencialmente general muerte súbita diabéticos. Objetivo. Identificar estados asociados de comorbilidad (alteraciones de lípidos y fibrinógeno (FB) plasmáticos), con los trastornos de la neuropatía diabética autonómica cardiovascular (NDAC). Material y métodos. Se estudiaron 100 sujetos (50 enfermos de DMNID con más de cinco años de evolución y 50 controles sanos), de uno u otro sexo, de entre 45 y 60 años. Todos se sometieron a pruebas fisiológicas autonómicas y determinación de FB y lípidos séricos. Se buscó asociación mediante modelo de X² y correlación. Resultados. Se encontró una prevalencia de NDAC en 48 por ciento de los diabéticos varones y 32 por ciento de las mujeres enfermas. Niveles de FB inadecuados en 40 por ciento de los enfermos y 10 por ciento de los controles. Asociaciones significativas (p<0.005) para triglicéridos, colesterol, HgAIc, colesterol y C-LBD. Conclusiones. Es posible caracterizar el estado de comorbilidad que aguardan las variables estudiadas, permitiendo la estratificación pronóstica en la DMNID en relación a la NDAC

Células ganglionares en transplante cardíaco consideraciones generales / Ganglion cells in cardiac transplantation: generals considerations

A la fecha no hay estudios que relacionen las células ganglionares y la reinervación en los trasnplantes cardíacos. En base a un hallazgo fortuito en autopsia hicimos un análisis teórico en torno a este tópico, utilizando los experimentos que sobre este aspecto han hecho diferentes autores en corazones humanos 1,8,11,19,20,22,25,28, y los experimentos utilizando modelos biológicos en peces 9,10,23,32 que reproducen las condiciones que se generan post transplante cardíaco en los humanos. En el humano se han descrito aislados casos de reinervación funcional post transplante de corazón 19. ¿Será que en estos pacientes se dío el microambiente necesario para que se diera este proceso, aunado a la posible génesis de sustancias regeneradoras de tejido nervioso? Sugerimos la posibilidad (de utilizar sustancias que favorezcan la neuritogénesis y el neurotrofismo (Factor de crecimiento Neural 14,15,18 y/o Transglutaminasa 24 favoreciendo por ende el funcionamiento cardíaco

Diagnostic Values of SPACE Test in Corpus Cavernous Smooth Muscle / 대한비뇨기과학회지

Purpose: The ideal neurourophysiologic investigatory technique would objectively and quantitatively evaluate functional status of all parts of the neurologic network involved in obtaining and maintaining penile erection. We assessed electrical activity of the corpus cavernous smooth muscle in normal and neurogenic erectile dysfunction men using SPACE. Material and Methods: A total of 39 normal subjects and 40 neurogenic erectile dysfunction patients underwent single potential analysis of cavernous electricity(SPACE) with a 2-channel EMG amplifier and surface electrodes. The electrical potentials were processed with the cut off frequencies at 0.3 - 32 Hz, a paper speed of 0.5cm/sec, and a range of amplitude of 0.5mV. Results: In 35 of 39 normal subjects(89.7%) and 5 of 10 incomplete suprasacral spinal cord injury patients, similar single potentials of uniform shape were recorded. In patients with peripheral autonomic denervation, irregular shape potentials with higher frequency and lower amplitude were found. In 3 of 5 patients with long standing diabetes(over 15 years), SPACE shows electrical silence. Conclusion: These results suggest that SPACE test is a useful noninvasive and reproducible method for evaluating cavernous innervation in erectile dysfunction. Furthermore, the single potential means intact cavernous innervation.