Objectives. We sought to assess acute changes in systemic and pulmonary hemodynamics and microscopic artery lesions following extended renal artery denervation (RDN). Background. RDN has been proposed to reduce sympathetic nervous system hyperactivation. Although the effects of RDN on systemic circulation and overall sympathetic activity have been studied, data on the impact of RDN on pulmonary hemodynamics is lacking. Methods. The study comprised 13 normotensive Landrace pigs. After randomization, 7 animals were allocated to the group of bilateral RDN and 6 animals to the group of a sham procedure (SHAM). Hemodynamic measures, cannulation, and balloon-based occlusion of the renal arteries were performed in both groups. In the RDN group, radiofrequency ablation was performed in all available arteries and their segments. An autopsy study of the renal arteries was carried out in both groups. Results. The analysis was performed on 12 pigs (6 in either group) since pulmonary thromboembolism occurred in one case. A statistically significant drop in the mean diastolic pulmonary artery pressure (PAP) was detected in the RDN group when compared with the SHAM group (change by and , correspondingly; ). In 5 out of 6 pigs in the RDN group, a significant decrease in systemic systolic blood pressure was found, when compared with baseline ( vs. , ), and a lower mean pulmonary vascular resistance (PVR) ( vs. , ) after ablation was found. Artery dissections were found in both groups, with prevalence in animals after RDN. Conclusions. Extensive RDN leads to a rapid and significant decrease in PAP. In the majority of cases, RDN is associated with an acute lowering of systolic blood pressure and PVR. Extended RDN is associated with artery wall lesions and thrombus formation underdiagnosed by angiography.

中文翻译：

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延长肾动脉去神经支配与动脉壁病变和急性全身和肺血流动力学变化有关：一项假对照实验研究

目标。我们试图评估延长肾动脉去神经支配 (RDN) 后全身和肺血流动力学和微观动脉病变的急性变化。背景。RDN 已被提议用于减少交感神经系统过度激活。尽管已经研究了 RDN 对全身循环和整体交感神经活动的影响，但缺乏关于 RDN 对肺血流动力学影响的数据。方法. 该研究包括 13 头血压正常的长白猪。随机化后，7只动物被分配到双侧RDN组，6只动物被分配到假手术组（SHAM）。两组均进行了血流动力学测量、插管和基于球囊的肾动脉闭塞。在 RDN 组中，对所有可用动脉及其节段进行了射频消融。对两组进行了肾动脉的尸检研究。结果。由于 1 例发生肺血栓栓塞，因此对 12 头猪（每组 6 头）进行了分析。与 SHAM 组相比，RDN 组的平均舒张期肺动脉压 (PAP) 显着下降（变化幅度为和,相应地;）。与基线相比，RDN 组 6 头猪中有 5 头发现全身收缩压显着降低（对比, )，以及较低的平均肺血管阻力 (PVR) (对比, )发现消融后。两组均发现动脉夹层，在 RDN 后动物中普遍存在。结论。广泛的 RDN 导致 PAP 快速显着下降。在大多数情况下，RDN 与收缩压和 PVR 的急性降低有关。扩展的 RDN 与血管造影未确诊的动脉壁病变和血栓形成有关。