Perivascular Innervation of the Pulmonary Artery in Human and Swine: A Comparative Study for the Development of an Exper
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nervation of the Pulmonary Artery in Human and Swine: A Comparative Study for the Development of an Experimental Model of Denervation
E. G. Koshevaya, L. B. Mitrofanova, N. S. Goncharova, H. I. Condori Leandro, A. D. Vakhrushev, L. E. Korobchenko, L. A. Murashova, M. M. Galagudza, A. A. Perminova, O. M. Moiseeva, and E. N. Mikhaylov Translated from Byulleten’ Eksperimental’noi Biologii i Meditsiny, Vol. 170, No. 8, pp. 260-264, August, 2020 Original article submitted June 2, 2020 For studying the possibility of using catheter denervation of the pulmonary artery for the treatment of pulmonary hypertension, large animals, such as pigs, are more suitable, because the diameter of the pulmonary artery in this case allows manipulation of the ablation catheter. The study of the perivascular adipose tissue of the trunk and bifurcation of the pulmonary artery in humans and pigs revealed differences in the density and diameter of nerve fibers, but their depth did not differ. Immunohistochemical analysis with different markers of the autonomic nervous system receptors revealed similar receptor profile in human and pigs, though the expression of all studied markers in pigs was less pronounced than in humans. These findings attest to similarity of the innervation of the pulmonary arteries in humans and pigs under normal conditions. Key Words: pulmonary hypertension; pulmonary artery denervation; innervation of the pulmonary artery
Pulmonary arterial hypertension is a pathophysiological condition characterized by increased pulmonary vascular resistance leading to right ventricular failure and premature death [7]. The pathogenesis of pulmonary hypertension (PH) is associated with increased activation of the sympathetic nervous system (SNS). There are also reports on enhanced activation of the renin—angiotensin—aldosterone system in patients with severe course of PH. Suppression of the sympathetic neurohormonal activation can be an effective therapeutic strategy in the treatment of PH. In experimental models of PH, the blockade of adrenergic receptors or signaling pathways of the renin—angiotensin—aldosterone system produced a positive effect on cardiac remodeling. However, the efficacy and safety of such V. A. Almazov National Medical Research Center, Ministry of Health of the Russian Federation, St. Petersburg, Russia. Address for correspondence: [email protected]. E. G. Koshevaya
treatment in clinical settings in patients with PH are is doubt [8]. Recently, new interventional approaches, such as pulmonary artery (PA) denervation and renal denervation have been used to decrease activation of the SNS in PH [13]. A recent study aimed at studying SNS hyperactivation in patients with PH associated with left ventricular heart failure demonstrated that PA denervation is associated with significant improvements in the hemodynamics and clinical outcomes in patients with combined pre- and post-capillary PH [15]. PA denervation is a novel endovascular catheter intervention therapy employing radiofrequency ablation to eliminate barorecepto
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