去肾交感神经术对猪急性心肌梗死后心功能及心室重构的影响

目的:探讨去肾交感神经术(renal sympathetic denervation,RDN)对急性心肌梗死(AMI)后心功能及心室重构的影响。方法:微球栓塞前降支中远端构建AMI猪模型。实验分组为:对照组,建模后未接受RDN(n=10);RDN组,建模后1周接受RDN(n=10)。建模后1周(RDN前)及建模后4周对两组猪利用超声心动图检测左心功能和左心室大小,并检测相关血清学指标。结果:建模后4周,与对照组相比,RDN组的左室射血分数(EF)明显升高[(55.34±7.12)%对(50.52±2.23)%,P=0.035],左室收缩末期内径(LVESD)明显减小[(24.43±2.23)mm对(29.33±3.53)mm,P=0.020];与自身RDN治疗前比较,RDN组EF[(55.34±7.12)%对(49.23±4.58)%,P=0.034]和E/A(0.93±0.24对0.85±0.10,P=0.048)明显升高,LVESD明显减小[(24.43±2.23)mm对(26.55±2.11)mm,P=0.048];RDN组的去甲肾上腺素[(247.31±103.13)ng/L对(337.90±60.33)ng/L,P0.05]和肾素[(414.92±202.40)ng/L对(587.54±235.62)ng/L,P0.05)]水平显著低于对照组。结论:RDN可以提高猪AMI后的左心收缩功能,改善心室重构。     

Renal Sympathetic Denervation System via Intraluminal Ultrasonic Ablation: Therapeutic Intravascular Ultrasound Design and Preclinical Evaluation

Purpose

To assess the safety and performance of a nonfocused and nonballooned ultrasonic (US) catheter–based renal sympathetic denervation (RDN) system in normotensive swine.

Sténose de l’artère rénale à distance d’une dénervation rénale pour HTA résistante

The onset of renal artery stenosis following a renal denervation is rare and occurs in the first few months after renal denervation. We report the onset of renal artery stenosis a long time after the renal denervation for resistant hypertension. This is a 74 year-old patient who stopped smoking in 1980 and who was treated for dyslipidemia with a revascularized coronary artery disease in 2011, a well-stabilized peripheral arterial disease since 2001, a stable asymptomatic carotid atheroma and a good kidney function. His hypertension known since 1995 became resistant. After the control of renal arteries by angio-CT scan, he had a renal denervation in October 2012. His blood pressure decreased 3 months later confirmed by self-blood pressure monitoring (SBPM) and ambulatory blood pressure monitoring (ABPM) with a CT scan with a non-significant renal artery stenosis in January 2014. He remained normotensive under treatment until July 2015 but his hypertension became uncontrolled at the end of 2015 then resistant and severe confirmed by SBPM in April 2017, despite a 5-drug antihypertensive treatment associated to atorvastatin and clopidogrel confirmed by SBPM in April 2017. A left post-ostial renal artery stenosis with decrease in size of left kidney and cortex as compared to 2011 was detected at CT and treated by angioplasty. It was associated with a rapid decrease in blood pressure but unfortunately a new increase related to a restenosis occurred at the end of 2017, which justified a new angioplasty. Discussion about the etiology and the management of this renal post-denervation late stenosis.     

Apigenin inhibits sciatic nerve denervation–induced muscle atrophy

Introduction: Apigenin (AP) has been reported to elicit anti‐inflammatory effects. In this study, we investigated the effect of AP on sciatic nerve denervation–induced muscle atrophy. Methods: Sciatic nerve–denervated mice were fed a 0.1% AP‐containing diet for 2 weeks. Muscle weight and cross‐sectional area (CSA), and the expression of atrophic genes and inflammatory cytokines in the gastrocnemius were analyzed. Results: Denervation significantly induced muscle atrophy. However, values for muscle weight and CSA were greater in the denervated muscle of the AP mice than the controls. AP suppressed the expression of MuRF1, but upregulated both myosin heavy chain (MHC) and MHC type IIb. AP also significantly suppressed expression of tumor necrosis‐alpha in the gastrocnemius and soleus muscles, and interleukin‐6 expression in the soleus muscle. Discussion: AP appears to inhibit denervation‐induced muscle atrophy, which may be due in part to its inhibitory effect on inflammatory processes within muscle. Muscle Nerve 58 : 314–318, 2018     

Long‐term neuromuscular outcomes of west nile virus infection: A clinical and electromyographic evaluation of patients with a history of infection

Introduction: Neuromuscular clinical manifestations during acute West Nile virus (WNV) infection are well documented; however, long‐term neurologic outcomes still require investigation. Methods: We conducted a long‐term follow‐up study in patients with history of WNV infection. Of the 117 patients who participated in neurologic and neurocognitive evaluations, 30 were referred for neuromuscular and electrodiagnostic evaluation based on abnormal findings. Results: We found that 33% of these patients (10 of 30) showed abnormalities on nerve conduction and/or needle electromyography due to primary or secondary outcomes of WNV infection. Most common electrodiagnostic findings and causes of long‐term disability were related to anterior horn cell poliomyelitis (WNV poliomyelitis). Electrical data on these patient populations were similar to those observed in chronic poliomyelitis. Discussion: With more than 16,000 cases of WNV neuroinvasive disease reported across the USA since 1999, understanding clinical outcomes from infection will provide a resource for physicians managing long‐term care of these patients. Muscle Nerve 57 : 77–82, 2018     

Adipose stem cells enhance myoblast proliferation via acetylcholine and extracellular signal–regulated kinase 1/2 signaling

Introduction: In this study we investigated the interaction between adipose tissue–derived stem cells (ASCs) and myoblasts in co‐culture experiments. Methods: Specific inductive media were used to differentiate ASCs in vitro into a Schwann cell–like phenotype (differentiated adipose tissue–derived stem cells, or dASCs) and, subsequently, the expression of acetylcholine (ACh)‐related machinery was determined. In addition, the expression of muscarinic ACh receptors was examined in denervated rat gastrocnemius muscles. Results: In contrast to undifferentiated ASCs, dASCs expressed more choline acetyltransferase and vesicular acetylcholine transporter. When co‐cultured with myoblasts, dASCs enhanced the proliferation rate, as did ACh administration alone. Western blotting and pharmacological inhibitor studies showed that phosphorylated extracellular signal–regulated kinase 1/2 signaling mediated these effects. In addition, denervated muscle showed higher expression of muscarinic ACh receptors than control muscle. Discussion: Our findings suggest that dASCs promote proliferation of myoblasts through paracrine secretion of ACh, which could explain some of their regenerative capacity in vivo. Muscle Nerve 57 : 305–311, 2018     

Stellate ganglion blockade and bilateral cardiac sympathetic denervation in patients with life‐threatening ventricular arrhythmias

Autonomic modulation is being increasingly employed as a strategy to treat ventricular arrhythmias refractory to beta‐blockers, antiarrhythmic drugs, and catheter‐based ablation procedures. We report 6 patients with refractory ventricular tachycardia (VT) or ventricular fibrillation (VF) treated with stellate ganglion blockade (SGB) and/or bilateral cardiac sympathetic denervation (CSD). Our case series emphasizes the concept that the cardiac sympathetic nerves are important targets in the management of ventricular arrhythmias. SGB and CSD can be effective in suppressing VT/VF and can be offered to patients with refractory ventricular arrhythmias as an adjunct to conventional therapy.