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Sesa-Ashton G, Carnagarin R, Nolde JM, Muente I, Lee R, Macefield VG, Dawood T, Sata Y, Lambert EA, Lambert GW, Walton A, Kiuchi MG, Esler MD, Schlaich MP. Salt sensitivity risk derived from nocturnal dipping and 24-h heart rate predicts long-term blood pressure reduction following renal denervation. J Hypertens 2024; 42:922-927. [PMID: 38230602 DOI: 10.1097/hjh.0000000000003655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
BACKGROUND Renal denervation (RDN) has been consistently shown in recent sham-controlled clinical trials to reduce blood pressure (BP). Salt sensitivity is a critical factor in hypertension pathogenesis, but cumbersome to assess by gold-standard methodology. Twenty-four-hour average heart rate (HR) and mean arterial pressure (MAP) dipping, taken by ambulatory blood pressure monitoring (ABPM), stratifies patients into high, moderate, and low salt sensitivity index (SSI) risk categories. OBJECTIVES We aimed to assess whether ABPM-derived SSI risk could predict the systolic blood pressure reduction at long-term follow-up in a real-world RDN patient cohort. METHODS Sixty participants had repeat ABPM as part of a renal denervation long-term follow-up. Average time since RDN was 8.9 ± 1.2 years. Based on baseline ABPM, participants were stratified into low (HR < 70 bpm and MAP dipping > 10%), moderate (HR ≥70 bpm or MAP dipping ≤ 10%), and high (HR ≥ 70 bpm and MAP dipping ≤ 10%) SSI risk groups, respectively. RESULTS One-way ANOVA indicated a significant treatment effect ( P = 0.03) between low ( n = 15), moderate ( n = 35), and high ( n = 10) SSI risk with systolic BP reduction of 9.6 ± 3.7 mmHg, 8.4 ± 3.5 mmHg, and 28.2 ± 9.6 mmHg, respectively. Baseline BP was not significantly different between SSI Risk groups ( P = 0.18). High SSI risk independently correlated with systolic BP reduction ( P = 0.02). CONCLUSIONS Our investigation indicates that SSI risk may be a simple and accessible measure for predicting the BP response to RDN. However, the influence of pharmacological therapy on these participants is an important extraneous variable requiring testing in prospective or drug naive RDN cohorts.
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Affiliation(s)
- Gianni Sesa-Ashton
- Human Neurotransmitter and Neurovascular Hypertension & Kidney Diseases Laboratories, Baker Heart and Diabetes Institute, Melbourne
- Human Autonomic Neurophysiology Laboratory, Baker Heart and Diabetes Institute
| | - Revathy Carnagarin
- Dobney Hypertension Centre, Medical School - Royal Perth Hospital Unit and RPH Research Foundation, The University of Western Australia, Perth, Western Australia
| | - Janis M Nolde
- Dobney Hypertension Centre, Medical School - Royal Perth Hospital Unit and RPH Research Foundation, The University of Western Australia, Perth, Western Australia
| | - Ida Muente
- Dobney Hypertension Centre, Medical School - Royal Perth Hospital Unit and RPH Research Foundation, The University of Western Australia, Perth, Western Australia
| | - Rebecca Lee
- Human Neurotransmitter and Neurovascular Hypertension & Kidney Diseases Laboratories, Baker Heart and Diabetes Institute, Melbourne
| | - Vaughan G Macefield
- Human Autonomic Neurophysiology Laboratory, Baker Heart and Diabetes Institute
| | - Tye Dawood
- Human Autonomic Neurophysiology Laboratory, Baker Heart and Diabetes Institute
| | - Yusuke Sata
- Human Neurotransmitter and Neurovascular Hypertension & Kidney Diseases Laboratories, Baker Heart and Diabetes Institute, Melbourne
- Department of Cardiology, Alfred Health, Melbourne, Victoria
| | - Elisabeth A Lambert
- Iverson Health Innovation Research Institute and School of Health Sciences, Swinburne University of Technology, Melbourne
| | - Gavin W Lambert
- Iverson Health Innovation Research Institute and School of Health Sciences, Swinburne University of Technology, Melbourne
| | - Antony Walton
- Department of Cardiology, Alfred Health, Melbourne, Victoria
| | - Marcio G Kiuchi
- Dobney Hypertension Centre, Medical School - Royal Perth Hospital Unit and RPH Research Foundation, The University of Western Australia, Perth, Western Australia
| | - Murray D Esler
- Human Neurotransmitter and Neurovascular Hypertension & Kidney Diseases Laboratories, Baker Heart and Diabetes Institute, Melbourne
- Department of Cardiology, Alfred Health, Melbourne, Victoria
| | - Markus P Schlaich
- Human Neurotransmitter and Neurovascular Hypertension & Kidney Diseases Laboratories, Baker Heart and Diabetes Institute, Melbourne
- Dobney Hypertension Centre, Medical School - Royal Perth Hospital Unit and RPH Research Foundation, The University of Western Australia, Perth, Western Australia
- Departments of Cardiology and Nephrology, Royal Perth Hospital, Perth, Western Australia, Australia
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Huynh Q, Wexler N, Smith J, Wright L, Ho F, Allwood R, Sata Y, Manca S, Howden E, Marwick TH. Associations between symptoms and functional capacity in patients after COVID-19 infection and community controls. Intern Med J 2023; 53:1540-1547. [PMID: 37490523 PMCID: PMC10947235 DOI: 10.1111/imj.16185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 06/23/2023] [Indexed: 07/27/2023]
Abstract
BACKGROUND Post-acute sequelae of COVID-19 (PASC or 'long COVID') reflect ongoing symptoms, but these are non-specific and common in the wider community. Few reports of PASC have been compared with a control group. AIMS To compare symptoms and objective impairment of functional capacity in patients with previous COVID-19 infection with uninfected community controls. METHODS In this community-based, cross-sectional study of functional capacity, 562 patients from Western Melbourne who had recovered from COVID-19 infections in 2021 and 2022 were compared with controls from the same community and tested for functional capacity pre-COVID-19. Functional impairment (<85% of the predicted response) was assessed using the Duke Activity Status Index (DASI) and 6-min walk distance (6MWD) test. A subgroup underwent cardiopulmonary exercise testing before and after exercise training. RESULTS Of 562 respondents (age 54 ± 12 years, 69% women), 389 were symptomatic. Functional impairment (<85% predicted metabolic equivalent of tasks) was documented by DASI in 149 participants (27%), and abnormal 6MWD (<85% predicted) was observed in 14% of the symptomatic participants. Despite fewer risk factors and younger age, patients with COVID-19 had lower functional capacity by 6MWD (P < 0.001) and more depression (P < 0.001) than controls. In a pilot group of seven participants (age 58 ± 12 years, two women, VO2 18.9 ± 5.7 mL/kg/min), repeat testing after exercise training showed a 20% increase in peak workload. CONCLUSIONS Although most participants (69%) had symptoms consistent with long COVID, significant subjective functional impairment was documented in 27% and objective functional impairment in 14%. An exercise training programme might be beneficial for appropriately selected patients.
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Affiliation(s)
- Quan Huynh
- Imaging Research LaboratoryBaker Heart and Diabetes InstituteMelbourneVictoriaAustralia
- Baker Department of Cardiometabolic HealthUniversity of MelbourneMelbourneVictoriaAustralia
| | - Noah Wexler
- Imaging Research LaboratoryBaker Heart and Diabetes InstituteMelbourneVictoriaAustralia
- Department of CardiologyWestern HealthMelbourneVictoriaAustralia
| | - Joel Smith
- Imaging Research LaboratoryBaker Heart and Diabetes InstituteMelbourneVictoriaAustralia
| | - Leah Wright
- Imaging Research LaboratoryBaker Heart and Diabetes InstituteMelbourneVictoriaAustralia
- Department of CardiologyWestern HealthMelbourneVictoriaAustralia
| | - Felicia Ho
- Imaging Research LaboratoryBaker Heart and Diabetes InstituteMelbourneVictoriaAustralia
- Department of CardiologyWestern HealthMelbourneVictoriaAustralia
| | - Richard Allwood
- Imaging Research LaboratoryBaker Heart and Diabetes InstituteMelbourneVictoriaAustralia
| | - Yusuke Sata
- Imaging Research LaboratoryBaker Heart and Diabetes InstituteMelbourneVictoriaAustralia
| | - Stefano Manca
- Imaging Research LaboratoryBaker Heart and Diabetes InstituteMelbourneVictoriaAustralia
| | - Erin Howden
- Imaging Research LaboratoryBaker Heart and Diabetes InstituteMelbourneVictoriaAustralia
- Baker Department of Cardiometabolic HealthUniversity of MelbourneMelbourneVictoriaAustralia
| | - Thomas H. Marwick
- Imaging Research LaboratoryBaker Heart and Diabetes InstituteMelbourneVictoriaAustralia
- Baker Department of Cardiometabolic HealthUniversity of MelbourneMelbourneVictoriaAustralia
- Department of CardiologyWestern HealthMelbourneVictoriaAustralia
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Sesa-Ashton G, Nolde JM, Muente I, Carnagarin R, Lee R, Macefield VG, Dawood T, Sata Y, Lambert EA, Lambert GW, Walton A, Kiuchi MG, Esler MD, Schlaich MP. Catheter-Based Renal Denervation: 9-Year Follow-Up Data on Safety and Blood Pressure Reduction in Patients With Resistant Hypertension. Hypertension 2023; 80:811-819. [PMID: 36762561 DOI: 10.1161/hypertensionaha.122.20853] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
BACKGROUND Recent sham-controlled randomized clinical trials have confirmed the safety and efficacy of catheter-based renal denervation (RDN). Long-term safety and efficacy data beyond 3 years are scarce. Here, we report on outcomes after RDN in a cohort of patients with resistant hypertension with an average of ≈9-year follow-up (FU). METHODS We recruited patients with resistant hypertension who were previously enrolled in various RDN trials applying radiofrequency energy for blood pressure (BP) lowering. All participants had baseline assessments before RDN and repeat assessment at long-term FU including medical history, automated office and ambulatory BP measurement, and routine blood and urine tests. We analyzed changes between baseline and long-term FU. RESULTS A total of 66 participants (mean±SD, 70.0±10.3 years; 76.3% men) completed long-term FU investigations with a mean of 8.8±1.2 years post-procedure. Compared with baseline, ambulatory systolic BP was reduced by -12.1±21.6 (from 145.2 to 133.1) mm Hg (P<0.0001) and diastolic BP by -8.8±12.8 (from 81.2 to 72.7) mm Hg (P<0.0001). Mean heart rate remained unchanged. At long-term FU, participants were on one less antihypertensive medication compared with baseline (P=0.0052). Renal function assessed by estimated glomerular filtration rate fell within the expected age-associated rate of decline from 71.1 to 61.2 mL/min per 1.73 m2. Time above target was reduced significantly from 75.0±25.9% at baseline to 47.3±30.3% at long-term FU (P<0.0001). CONCLUSIONS RDN results in a significant and robust reduction in both office and ambulatory systolic and diastolic BP at ≈9-year FU after catheter-based RDN on less medication and without evidence of adverse consequences on renal function.
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Affiliation(s)
- Gianni Sesa-Ashton
- Human Neurotransmitter and Neurovascular Hypertension and Kidney Diseases Laboratories (G.S.-A., R.L., Y.S., M.D.E., M.P.S.), Baker Heart and Diabetes Institute, Melbourne, Australia.,Human Autonomic Neurophysiology Laboratory (G.S.-A., V.G.M., T.D.), Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Janis M Nolde
- Dobney Hypertension Centre, Medical School-Royal Perth Hospital Unit and RPH Research Foundation, The University of Western Australia (J.M.N., I.M., R.C., M.G.K., M.P.S.)
| | - Ida Muente
- Dobney Hypertension Centre, Medical School-Royal Perth Hospital Unit and RPH Research Foundation, The University of Western Australia (J.M.N., I.M., R.C., M.G.K., M.P.S.)
| | - Revathy Carnagarin
- Dobney Hypertension Centre, Medical School-Royal Perth Hospital Unit and RPH Research Foundation, The University of Western Australia (J.M.N., I.M., R.C., M.G.K., M.P.S.)
| | - Rebecca Lee
- Human Neurotransmitter and Neurovascular Hypertension and Kidney Diseases Laboratories (G.S.-A., R.L., Y.S., M.D.E., M.P.S.), Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Vaughan G Macefield
- Human Autonomic Neurophysiology Laboratory (G.S.-A., V.G.M., T.D.), Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Tye Dawood
- Human Autonomic Neurophysiology Laboratory (G.S.-A., V.G.M., T.D.), Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Yusuke Sata
- Human Neurotransmitter and Neurovascular Hypertension and Kidney Diseases Laboratories (G.S.-A., R.L., Y.S., M.D.E., M.P.S.), Baker Heart and Diabetes Institute, Melbourne, Australia.,Department of Cardiology, Alfred Health, Melbourne, Victoria, Australia (Y.S., A.W., M.D.E.)
| | - Elisabeth A Lambert
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Australia (E.A.L., G.W.L.)
| | - Gavin W Lambert
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Australia (E.A.L., G.W.L.)
| | - Antony Walton
- Department of Cardiology, Alfred Health, Melbourne, Victoria, Australia (Y.S., A.W., M.D.E.)
| | - Marcio G Kiuchi
- Dobney Hypertension Centre, Medical School-Royal Perth Hospital Unit and RPH Research Foundation, The University of Western Australia (J.M.N., I.M., R.C., M.G.K., M.P.S.)
| | - Murray D Esler
- Human Neurotransmitter and Neurovascular Hypertension and Kidney Diseases Laboratories (G.S.-A., R.L., Y.S., M.D.E., M.P.S.), Baker Heart and Diabetes Institute, Melbourne, Australia.,Department of Cardiology, Alfred Health, Melbourne, Victoria, Australia (Y.S., A.W., M.D.E.)
| | - Markus P Schlaich
- Human Neurotransmitter and Neurovascular Hypertension and Kidney Diseases Laboratories (G.S.-A., R.L., Y.S., M.D.E., M.P.S.), Baker Heart and Diabetes Institute, Melbourne, Australia.,Dobney Hypertension Centre, Medical School-Royal Perth Hospital Unit and RPH Research Foundation, The University of Western Australia (J.M.N., I.M., R.C., M.G.K., M.P.S.).,Departments of Cardiology (M.P.S.), Royal Perth Hospital, Western Australia.,Nephrology (M.P.S.), Royal Perth Hospital, Western Australia
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Jama H, RhysJones D, Nakai M, Yao CKK, Climie RE, Sata Y, Anderson D, Creek DJ, Head GA, Kaye DM, Mackay C, Muir J, Marques FZ. S-57-3: GUT MICROBIAL METABOLITES LOWER 24-HOUR SYSTOLIC BLOOD PRESSURE IN HYPERTENSIVE PATIENTS. J Hypertens 2023. [DOI: 10.1097/01.hjh.0000914028.19216.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Dinakis E, Nakai M, Gill P, Ribeiro R, Yiallourou S, Sata Y, Muir J, Carrington M, Head GA, Kaye DM, Marques FZ. Association Between the Gut Microbiome and Their Metabolites With Human Blood Pressure Variability. Hypertension 2022; 79:1690-1701. [PMID: 35674054 DOI: 10.1161/hypertensionaha.122.19350] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Blood pressure (BP) variability is an independent risk factor for cardiovascular events. Recent evidence supports a role for the gut microbiota in BP regulation. However, whether the gut microbiome is associated with BP variability is yet to be determined. Here, we aimed to investigate the interplay between the gut microbiome and their metabolites in relation to BP variability. METHODS Ambulatory BP monitoring was performed in 69 participants from Australia (55.1% women; mean±SD, 59.8±7.26 years; body mass index, 25.2±2.83 kg/m2). These data were used to determine nighttime dipping, morning BP surge (MBPS) and BP variability as SD. The gut microbiome was determined by 16S ribosomal RNA (rRNA) sequencing and metabolite levels by gas chromatography. RESULTS We identified specific taxa associated with systolic BP variability, nighttime dipping, and MBPS. Notably, Alistipesfinegoldii and Lactobacillus spp. were only present in participants within the normal ranges of BP variability, MBPS and dipping, while Prevotella spp. and Clostridium spp., were found to be present in extreme dippers and the highest quartiles of BP SD and MBPS. There was a negative association between MBPS and microbial α-diversity (r=-0.244, P=0.046). MBPS was also negatively associated with plasma levels of microbial metabolites called short-chain fatty acids (r=-0.305, P=0.020), particularly acetate (r=-0.311, P=0.017). CONCLUSIONS Gut microbiome diversity, levels of microbial metabolites, and the bacteria Alistipesfinegoldii and Lactobacillus were associated with lower BP variability and Clostridium and Prevotella with higher BP variability. Thus, our findings suggest the gut microbiome and metabolites may be involved in the regulation of BP variability.
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Affiliation(s)
- Evany Dinakis
- Hypertension Research Laboratory, School of Biological Sciences (E.D., M.N., F.Z.M), Monash University, Melbourne, Australia
| | - Michael Nakai
- Hypertension Research Laboratory, School of Biological Sciences (E.D., M.N., F.Z.M), Monash University, Melbourne, Australia
| | - Paul Gill
- Department of Gastroenterology (P.G., J.M.), Monash University, Melbourne, Australia
| | - Rosilene Ribeiro
- School of Life and Environmental Sciences, Charles Perkins Centre, University of Sydney, Australia (R.R.)
| | - Stephanie Yiallourou
- Central Clinical School, Faculty of Medicine Nursing and Health Sciences (Y.S., D.M.K.), Monash University, Melbourne, Australia.,Preclinical Disease and Prevention (S.Y., M.C.), Baker Heart and Diabetes Institute, Melbourne, Australia.,Department of Cardiology, Alfred Hospital, Melbourne, Australia (Y.S., D.M.K.)
| | - Yusuke Sata
- Neuropharmacology Laboratory (Y.S., G.A.H.), Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Jane Muir
- Department of Gastroenterology (P.G., J.M.), Monash University, Melbourne, Australia
| | - Melinda Carrington
- Preclinical Disease and Prevention (S.Y., M.C.), Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Geoffrey A Head
- Department of Pharmacology, Faculty of Medicine Nursing and Health Sciences (G.A.H.), Monash University, Melbourne, Australia.,Neuropharmacology Laboratory (Y.S., G.A.H.), Baker Heart and Diabetes Institute, Melbourne, Australia
| | - David M Kaye
- Central Clinical School, Faculty of Medicine Nursing and Health Sciences (Y.S., D.M.K.), Monash University, Melbourne, Australia.,Heart Failure Research Group (D.M.K., F.Z.M.), Baker Heart and Diabetes Institute, Melbourne, Australia.,Department of Cardiology, Alfred Hospital, Melbourne, Australia (Y.S., D.M.K.)
| | - Francine Z Marques
- Hypertension Research Laboratory, School of Biological Sciences (E.D., M.N., F.Z.M), Monash University, Melbourne, Australia.,Heart Failure Research Group (D.M.K., F.Z.M.), Baker Heart and Diabetes Institute, Melbourne, Australia
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6
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Batchelor RJ, Wong N, Liu DH, Chua C, William J, Tee SL, Sata Y, Bergin P, Hare J, Leet A, Taylor AJ, Patel HC, Burrell A, McGiffin D, Kaye DM. Vasoplegia Following Orthotopic Heart Transplantation: Prevalence, Predictors and Clinical Outcomes. J Card Fail 2021; 28:617-626. [PMID: 34974975 DOI: 10.1016/j.cardfail.2021.11.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 11/03/2021] [Accepted: 11/22/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Patients undergoing heart transplant are at high risk for postoperative vasoplegia. Despite its frequency and association with poor clinical outcomes, there remains no consensus definition for vasoplegia, and the predisposing risk factors for vasoplegia remain unclear. Accordingly, the aim of this study was to evaluate the prevalence, predictors, and clinical outcomes associated with vasoplegia in a contemporary cohort of patients undergoing heart transplantation. METHODS This was a retrospective cohort study of patients undergoing heart transplantation from January 2015 to December 2019. A binary definition of vasoplegia of a cardiac index of 2.5 L/min/m2 or greater and requirement for norepinephrine (≥5 µg/min), epinephrine (≥4 µg/min), or vasopressin (≥1 unit/h) to maintain a mean arterial blood pressure of 65 mm Hg, for 6 consecutive hours during the first 48 hours postoperatively, was used in determining prevalence. Given the relatively low threshold for the binary definition of vasoplegia, patients were divided into tertiles based on their cumulative vasopressor requirement in the 48 hours following transplant. Outcomes included all-cause mortality, intubation time, intensive care unit length of stay, and length of total hospitalization. RESULTS After exclusion of patients with primary cardiogenic shock, major bleeding, or overt sepsis, data were collected on 95 eligible patients. By binary definition, vasoplegia incidence was 66.3%. We separately stratified by actual vasopressor requirement tertile (high, intermediate, low). Stratified by tertile, patients with vasoplegia were older (52.7 ± 10.2 vs 46.8 ± 12.7 vs 44.4 ± 11.3 years, P = .02), with higher rates of chronic kidney disease (18.8% vs 32.3% vs 3.1%, P = .01) and were more likely to have been transplanted from left ventricular assist device support (n = 42) (62.5% vs 32.3% vs 37.5%, P = .03). Cardiopulmonary bypass time was prolonged in those that developed vasoplegia (155 min [interquartile range 135-193] vs 131 min [interquartile range 117-152] vs 116 min [interquartile range 102-155], P = .003). Intubation time and length of intensive care unit and hospital stay were significantly increased in those that developed vasoplegia; however, this difference did not translate to a significant increase in all-cause mortality at 30 days or 1 year. CONCLUSIONS Vasoplegia occurs at a high rate after heart transplantation. Older age, chronic kidney disease, mechanical circulatory support, and prolonged bypass time are all associated with vasoplegia; however, this study did not demonstrate an associated increase in all-cause mortality LAY SUMMARY: Patients undergoing heart transplantation are at high risk of vasoplegia, a condition defined by low blood pressure despite normal heart function. We found that vasoplegia was common after heart transplant, occurring in 60%-70% of patients after heart transplant after excluding those with other causes for low blood pressure. Factors implicated included age, poor kidney function, prolonged cardiopulmonary bypass time and preoperative left ventricular assist device support. We found no increased risk of death in patients with vasoplegia despite longer lengths of stay in intensive care and in hospital.
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Affiliation(s)
- Riley J Batchelor
- Department of Cardiology, Alfred Health, Melbourne, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Nathan Wong
- Department of Cardiology, Alfred Health, Melbourne, Australia
| | | | - Clara Chua
- Department of Cardiology, Alfred Health, Melbourne, Australia
| | - Jeremy William
- Department of Cardiology, Alfred Health, Melbourne, Australia
| | - Su Ling Tee
- Department of Cardiology, Alfred Health, Melbourne, Australia
| | - Yusuke Sata
- Department of Cardiology, Alfred Health, Melbourne, Australia
| | - Peter Bergin
- Department of Cardiology, Alfred Health, Melbourne, Australia
| | - James Hare
- Department of Cardiology, Alfred Health, Melbourne, Australia
| | - Angeline Leet
- Department of Cardiology, Alfred Health, Melbourne, Australia
| | - Andrew J Taylor
- Department of Cardiology, Alfred Health, Melbourne, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Hitesh C Patel
- Department of Cardiology, Alfred Health, Melbourne, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Heart Failure Research, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Aidan Burrell
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Heart Failure Research, Baker Heart and Diabetes Institute, Melbourne, Australia; Department of Intensive Care and Hyperbaric Medicine, The Alfred Hospital, Melbourne, VIC, Australia
| | - David McGiffin
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Department of Cardiothoracic Surgery, Alfred Health, Melbourne, Australia
| | - David M Kaye
- Department of Cardiology, Alfred Health, Melbourne, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Heart Failure Research, Baker Heart and Diabetes Institute, Melbourne, Australia.
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Sata Y, Burke SL, Eikelis N, Watson AMD, Gueguen C, Jackson KL, Lambert GW, Lim K, Denton KM, Schlaich MP, Head GA. Renal Deafferentation Prevents Progression of Hypertension and Changes to Sympathetic Reflexes in a Rabbit Model of Chronic Kidney Disease. Hypertension 2021; 78:1310-1321. [PMID: 34538104 DOI: 10.1161/hypertensionaha.121.17037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Yusuke Sata
- Neuropharmacology Laboratory (Y.S., S.L.B., A.M.D.W., C.G., K.L.J., K.L., G.A.H.), Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.,Human Neurotransmitters Laboratory (Y.S., M.P.S., G.W.L., N.E.), Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.,Faculty of Medicine, Nursing and Health Sciences, Central Clinical School (Y.S.), Monash University, Melbourne, VIC, Australia.,Department of Cardiology, Alfred Hospital, Melbourne, VIC, Australia (Y.S.)
| | - Sandra L Burke
- Neuropharmacology Laboratory (Y.S., S.L.B., A.M.D.W., C.G., K.L.J., K.L., G.A.H.), Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Nina Eikelis
- Human Neurotransmitters Laboratory (Y.S., M.P.S., G.W.L., N.E.), Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.,Iverson Health Innovation Research Institute and School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia (N.E., G.W.L.)
| | - Anna M D Watson
- Neuropharmacology Laboratory (Y.S., S.L.B., A.M.D.W., C.G., K.L.J., K.L., G.A.H.), Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.,Department of Diabetes, Central Clinical School (A.M.D.W.), Monash University, Melbourne, VIC, Australia
| | - Cindy Gueguen
- Neuropharmacology Laboratory (Y.S., S.L.B., A.M.D.W., C.G., K.L.J., K.L., G.A.H.), Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Kristy L Jackson
- Neuropharmacology Laboratory (Y.S., S.L.B., A.M.D.W., C.G., K.L.J., K.L., G.A.H.), Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.,Drug Discovery Biology, Monash Institute of Pharmaceutical Sciences (K.L.J), Monash University, Melbourne, VIC, Australia
| | - Gavin W Lambert
- Human Neurotransmitters Laboratory (Y.S., M.P.S., G.W.L., N.E.), Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.,Iverson Health Innovation Research Institute and School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia (N.E., G.W.L.)
| | - Kyungjoon Lim
- Neuropharmacology Laboratory (Y.S., S.L.B., A.M.D.W., C.G., K.L.J., K.L., G.A.H.), Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.,Department of Physiology, Anatomy and Microbiology, La Trobe University, Melbourne, VIC, Australia (K.L.)
| | - Kate M Denton
- Cardiovascular Program, Monash Biomedicine Discovery Institute and Department of Physiology, Monash University, Clayton, VIC, Australia (K.M.D.)
| | - Markus P Schlaich
- Human Neurotransmitters Laboratory (Y.S., M.P.S., G.W.L., N.E.), Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.,Departments of Cardiology and Nephrology, Dobney Hypertension Centre, School of Medicine, Royal Perth Hospital Unit, University of Western Australia, Royal Perth Hospital (M.P.S.)
| | - Geoffrey A Head
- Neuropharmacology Laboratory (Y.S., S.L.B., A.M.D.W., C.G., K.L.J., K.L., G.A.H.), Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.,Department of Pharmacology (G.A.H.), Monash University, Melbourne, VIC, Australia
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8
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Dinakis E, Nakai M, Gill PA, Yiallourou S, Sata Y, Muir J, Carrington M, Head GA, Kaye DM, Marques FZ. The Gut Microbiota and Their Metabolites in Human Arterial Stiffness. Heart Lung Circ 2021; 30:1716-1725. [PMID: 34452845 DOI: 10.1016/j.hlc.2021.07.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 07/21/2021] [Accepted: 07/26/2021] [Indexed: 01/13/2023]
Abstract
AIM Gut microbiota-derived metabolites, such as short-chain fatty acids (SCFAs) have vasodilator properties in animal and human ex vivo arteries. However, the role of the gut microbiota and SCFAs in arterial stiffness in humans is still unclear. Here we aimed to determine associations between the gut microbiome, SCFA and their G-protein coupled sensing receptors (GPCRs) in relation to human arterial stiffness. METHODS Ambulatory arterial stiffness index (AASI) was determined from ambulatory blood pressure (BP) monitoring in 69 participants from regional and metropolitan regions in Australia (55.1% women; mean, 59.8± SD, 7.26 years of age). The gut microbiome was determined by 16S rRNA sequencing, SCFA levels by gas chromatography, and GPCR expression in circulating immune cells by real-time PCR. RESULTS There was no association between metrics of bacterial α and β diversity and AASI or AASI quartiles in men and women. We identified two main bacteria taxa that were associated with AASI quartiles: Lactobacillus spp. was only present in the lowest quartile, while Clostridium spp. was present in all quartiles but the lowest. AASI was positively associated with higher levels of plasma, but not faecal, butyrate. Finally, we identified that the expression of GPR43 (FFAR2) and GPR41 (FFAR3) in circulating immune cells were negatively associated with AASI. CONCLUSIONS Our results suggest that arterial stiffness is associated with lower levels of the metabolite-sensing receptors GPR41/GPR43 in humans, blunting its response to BP-lowering metabolites such as butyrate. The role of Lactobacillus spp. and Clostridium spp., as well as butyrate-sensing receptors GPR41/GPR43, in human arterial stiffness needs to be determined.
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Affiliation(s)
- Evany Dinakis
- Hypertension Research Laboratory, School of Biological Sciences, Monash University, Melbourne, Vic, Australia
| | - Michael Nakai
- Hypertension Research Laboratory, School of Biological Sciences, Monash University, Melbourne, Vic, Australia
| | - Paul A Gill
- Department of Gastroenterology, Monash University, Melbourne, Vic, Australia
| | - Stephanie Yiallourou
- Preclinical Disease and Prevention, Baker Heart and Diabetes Institute, Melbourne, Vic, Australia
| | - Yusuke Sata
- Neuropharmacology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Vic, Australia; Central Clinical School, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, Vic, Australia; Department of Cardiology, Alfred Hospital, Melbourne, Vic, Australia
| | - Jane Muir
- Department of Gastroenterology, Monash University, Melbourne, Vic, Australia
| | - Melinda Carrington
- Preclinical Disease and Prevention, Baker Heart and Diabetes Institute, Melbourne, Vic, Australia
| | - Geoffrey A Head
- Neuropharmacology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Vic, Australia; Department of Pharmacology, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, Vic, Australia
| | - David M Kaye
- Central Clinical School, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, Vic, Australia; Department of Cardiology, Alfred Hospital, Melbourne, Vic, Australia; Heart Failure Research Group, Baker Heart and Diabetes Institute, Melbourne, Vic, Australia
| | - Francine Z Marques
- Hypertension Research Laboratory, School of Biological Sciences, Monash University, Melbourne, Vic, Australia; Heart Failure Research Group, Baker Heart and Diabetes Institute, Melbourne, Vic, Australia.
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9
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Lim K, Burke SL, Marques FZ, Jackson KL, Gueguen C, Sata Y, Armitage JA, Head GA. Leptin and Melanocortin Signaling Mediates Hypertension in Offspring From Female Rabbits Fed a High-Fat Diet During Gestation and Lactation. Front Physiol 2021; 12:693157. [PMID: 34248679 PMCID: PMC8264761 DOI: 10.3389/fphys.2021.693157] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 05/24/2021] [Indexed: 01/02/2023] Open
Abstract
Maternal high-fat diet in rabbits leads to hypertension and elevated renal sympathetic nerve activity (RSNA) in adult offspring but whether this is due to adiposity or maternal programming is unclear. We gave intracerebroventricular (ICV) and ventromedial hypothalamus (VMH) administration of leptin-receptor antagonist, α-melanocyte-stimulating hormone (αMSH), melanocortin-receptor antagonist (SHU9119), or insulin-receptor (InsR) antagonist to conscious adult offspring from mothers fed a high-fat diet (mHFD), control diet (mCD), or mCD offspring fed HFD for 10d (mCD10d, to deposit equivalent fat but not during development). mHFD and mCD10d rabbits had higher mean arterial pressure (MAP, +6.4 mmHg, +12.1 mmHg, p < 0.001) and RSNA (+2.3 nu, +3.2 nu, p < 0.01) than mCD, but all had similar plasma leptin. VMH leptin-receptor antagonist reduced MAP (−8.0 ± 3.0 mmHg, p < 0.001) in mCD10d but not in mHFD or mCD group. Intracerebroventricular leptin-receptor antagonist reduced MAP only in mHFD rabbits (p < 0.05). Intracerebroventricular SHU9119 reduced MAP and RSNA in mHFD but only reduced MAP in the mCD10d group. VMH αMSH increased RSNA (+85%, p < 0.001) in mHFD rabbits but ICV αMSH increased RSNA in both mHFD and mCD10d rabbits (+45%, +51%, respectively, p < 0.001). The InsR antagonist had no effect by either route on MAP or RSNA. Hypothalamic leptin receptor and brain-derived neurotrophic factor (BDNF) mRNA were greater in mHFD compared with mCD rabbits and mCD10d rabbits. In conclusion, the higher MAP in mHFD and mCD10d offspring was likely due to greater central leptin signaling at distinct sites within the hypothalamus while enhanced melanocortin contribution was common to both groups suggesting that residual body fat was mainly responsible. However, the effects of SHU9119 and αMSH on RSNA pathways only in mHFD suggest a maternal HFD may program sympatho-excitatory capacity in these offspring and that this may involve increased leptin receptor and BDNF expression.
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Affiliation(s)
- Kyungjoon Lim
- Neuropharmacology Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.,Department of Physiology, Anatomy and Microbiology, La Trobe University, Bundoora, VIC, Australia
| | - Sandra L Burke
- Neuropharmacology Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Francine Z Marques
- Heart Failure Research Group, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.,Hypertension Research Laboratory, School of Biological Sciences, Faculty of Science, Monash University, Clayton, VIC, Australia
| | - Kristy L Jackson
- Neuropharmacology Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Cindy Gueguen
- Neuropharmacology Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Yusuke Sata
- Neuropharmacology Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.,Human Neurotransmitters Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.,Faculty of Medicine, Nursing and Health Sciences, Central Clinical School, Monash University, Melbourne, VIC, Australia.,Department of Cardiology, Alfred Hospital, Melbourne, VIC, Australia
| | - James A Armitage
- School of Medicine (Optometry), and IMPACT Institute for Innovation in Physical and Mental Health and Clinical Translation, Faculty of Health, Deakin University, Waurn Ponds, VIC, Australia
| | - Geoffrey A Head
- Neuropharmacology Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.,Department of Pharmacology, Monash University, Clayton, VIC, Australia
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10
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Kaiho T, Suzuki H, Sata Y, Shiina Y, Tanaka K, Yamamoto T, Sakairi Y, Wada H, Nakajima T, Yoshino I. P04.09 Real-Time CT Guided Video-Assisted Thoracoscopic Partial Resection of Peripheral Small-Sized Lung Tumors in Hybrid OR –A Phase 2 Trial–. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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11
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Sata Y, Burke SL, Gueguen C, Lim K, Watson AM, Jha JC, Eikelis N, Jackson KL, Lambert GW, Denton KM, Schlaich MP, Head GA. Contribution of the Renal Nerves to Hypertension in a Rabbit Model of Chronic Kidney Disease. Hypertension 2020; 76:1470-1479. [DOI: 10.1161/hypertensionaha.120.15769] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Overactivity of the sympathetic nervous system and high blood pressure are implicated in the development and progression of chronic kidney disease (CKD) and independently predict cardiovascular events in end-stage renal disease. To assess the role of renal nerves, we determined whether renal denervation (RDN) altered the hypertension and sympathoexcitation associated with a rabbit model of CKD. The model involves glomerular layer lesioning and uninephrectomy, resulting in renal function reduced by one-third and diuresis. After 3-week CKD, blood pressure was 13±2 mm Hg higher than at baseline (P<0.001), and compared with sham control rabbits, renal sympathetic nerve activity was 1.2±0.5 normalized units greater (P=0.01). The depressor response to ganglion blockade was also +8.0±3 mm Hg greater, but total norepinephrine spillover was 8.7±3.7 ng/min lower (bothP<0.05). RDN CKD rabbits only increased blood pressure by 8.0±1.5 mm Hg. Renal sympathetic activity, the response to ganglion blockade and diuresis were similar to sham denervated rabbits (non-CKD). CKD rabbits had intact renal sympathetic baroreflex gain and range, as well as normal sympathetic responses to airjet stress. However, hypoxia-induced sympathoexcitation was reduced by −9±0.4 normalized units. RDN did not alter the sympathetic response to hypoxia or airjet stress. CKD increased oxidative stress markers Nox5 and MCP-1 (monocyte chemoattractant protein-1) in the kidney, but RDN had no effect on these measures. Thus, RDN is an effective treatment for hypertension in this model of CKD without further impairing renal function or altering the normal sympathetic reflex responses to various environmental stimuli.
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Affiliation(s)
- Yusuke Sata
- From the Neuropharmacology Laboratory (Y.S., S.L.B., C.G., K.L., K.L.J., G.A.H.), Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Human Neurotransmitters Laboratory (Y.S., M.P.S.), Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Faculty of Medicine, Nursing and Health Sciences, Central Clinical School (Y.S.), Monash University, Melbourne, VIC, Australia
- Department of Cardiology, Alfred Hospital, Melbourne, VIC, Australia (Y.S.)
| | - Sandra L. Burke
- From the Neuropharmacology Laboratory (Y.S., S.L.B., C.G., K.L., K.L.J., G.A.H.), Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Cindy Gueguen
- From the Neuropharmacology Laboratory (Y.S., S.L.B., C.G., K.L., K.L.J., G.A.H.), Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Kyungjoon Lim
- From the Neuropharmacology Laboratory (Y.S., S.L.B., C.G., K.L., K.L.J., G.A.H.), Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Department of Physiology, Anatomy and Microbiology, La Trobe University, Melbourne, VIC, Australia (K.L.)
| | - Anna M.D. Watson
- Department of Diabetes, Central Clinical School (A.M.D.W., J.C.J.), Monash University, Melbourne, VIC, Australia
| | - Jay C. Jha
- Department of Diabetes, Central Clinical School (A.M.D.W., J.C.J.), Monash University, Melbourne, VIC, Australia
| | - Nina Eikelis
- Iverson Health Innovation Research Institute and School of Health Science, Swinburne University of Technology, Hawthorn, VIC, Australia (N.E., G.W.L.)
| | - Kristy L. Jackson
- From the Neuropharmacology Laboratory (Y.S., S.L.B., C.G., K.L., K.L.J., G.A.H.), Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Gavin W. Lambert
- Iverson Health Innovation Research Institute and School of Health Science, Swinburne University of Technology, Hawthorn, VIC, Australia (N.E., G.W.L.)
| | - Kate M. Denton
- Cardiovascular Program, Monash Biomedicine Discovery Institute and Department of Physiology, Monash University, Clayton, VIC, Australia (K.M.D.)
| | - Markus P. Schlaich
- Human Neurotransmitters Laboratory (Y.S., M.P.S.), Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Dobney Hypertension Centre, School of Medicine, Royal Perth Hospital Unit, University of Western Australia (M.P.S.)
- Departments of Cardiology (M.P.S.), Royal Perth Hospital, Western Australia, Australia
- Nephrology (M.P.S.), Royal Perth Hospital, Western Australia, Australia
| | - Geoffrey A. Head
- From the Neuropharmacology Laboratory (Y.S., S.L.B., C.G., K.L., K.L.J., G.A.H.), Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Department of Pharmacology (G.A.H.), Monash University, Melbourne, VIC, Australia
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12
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Zaldivia MTK, Hering D, Marusic P, Sata Y, Lee R, Esler MD, Htun NM, Duval J, Hammond L, Flierl U, Wang X, Drummond GR, Walton A, Gardiner EE, Andrews RK, Schlaich MP, Peter K. Successful renal denervation decreases the platelet activation status in hypertensive patients. Cardiovasc Res 2020; 116:202-210. [PMID: 30715163 DOI: 10.1093/cvr/cvz033] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 12/18/2018] [Accepted: 01/31/2019] [Indexed: 12/23/2022] Open
Abstract
AIMS To determine whether renal denervation (RDN) in hypertensive patients affects the platelet activation status. METHODS AND RESULTS We investigated the effect of RDN on the platelet activation status in 41 hypertensive patients undergoing RDN. Ambulatory blood pressure (BP), plasma sympathetic neurotransmitter Neuropeptide Y, and platelet activation markers were measured at baseline, at 3 months, and 6 months after RDN. RDN significantly decreased BP at 3 months (150.6 ± 11.3/80.9 ± 11.4 mmHg to 144.7 ± 12.0/77.1 ± 11.1 mmHg; P < 0.01) and at 6 months (144.3 ± 13.8/78.3 ± 11.1 mmHg; P < 0.01). Plasma levels of the sympathetic neurotransmitter Neuropeptide Y, an indicator of sympathetic nerve activity, were significantly decreased at 3 months (0.29 ± 0.11 ng/mL to 0.23 ± 0.11 ng/mL; P < 0.0001) and at 6 months (0.22 ± 0.12 ng/mL; P < 0.001) after RDN. This was associated with a reduction in platelet membrane P-selectin expression (3 months, P < 0.05; 6 months, P < 0.05), soluble P-selectin (6 months, P < 0.05), circulating numbers of platelet-derived extracellular vesicles (EVs) (3 months, P < 0.001; 6 months, P < 0.01), and phosphatidylserine expressing EVs (3 months, P < 0.001; 6 months, P < 0.0001), indicative of a reduction in platelet activation status and procoagulant activity. Only patients who responded to RDN with a BP reduction showed inhibition of P-selectin expression at 3 months (P < 0.05) and 6 months (P < 0.05) as well as reduction of glycoprotein IIb/IIIa activation at 3 months (P < 0.05). Notably, 13 patients who took aspirin did not show significant reduction in platelet P-selectin expression following RDN. CONCLUSION Our results imply a connection between the sympathetic nervous system and the platelet activation status and provide a potential mechanistic explanation by which RDN can have favourable effects towards reducing cardiovascular complications.
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Affiliation(s)
- Maria T K Zaldivia
- Atherothrombosis and Vascular Biology, Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC 3004, Australia.,Department of Medicine, Monash University, Melbourne, Australia
| | - Dagmara Hering
- Neurovascular Hypertension and Kidney Disease, Baker Heart and Diabetes Institute, Melbourne, Australia.,Dobney Hypertension Centre, School of Medicine, Royal Perth Hospital Unit, University of Western Australia, Perth, Australia
| | - Petra Marusic
- Neurovascular Hypertension and Kidney Disease, Baker Heart and Diabetes Institute, Melbourne, Australia.,Dobney Hypertension Centre, School of Medicine, Royal Perth Hospital Unit, University of Western Australia, Perth, Australia
| | - Yusuke Sata
- Neurovascular Hypertension and Kidney Disease, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Rebecca Lee
- Neurovascular Hypertension and Kidney Disease, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Murray D Esler
- Department of Medicine, Monash University, Melbourne, Australia.,Heart Centre, Alfred Hospital, Melbourne, Australia
| | - Nay M Htun
- Atherothrombosis and Vascular Biology, Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC 3004, Australia.,Heart Centre, Alfred Hospital, Melbourne, Australia
| | - Jacqueline Duval
- Neurovascular Hypertension and Kidney Disease, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Louise Hammond
- Neurovascular Hypertension and Kidney Disease, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Ulrike Flierl
- Atherothrombosis and Vascular Biology, Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC 3004, Australia
| | - Xiaowei Wang
- Atherothrombosis and Vascular Biology, Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC 3004, Australia.,Department of Medicine, Monash University, Melbourne, Australia
| | - Grant R Drummond
- Department of Physiology, Anatomy and Microbiology, School of Life Sciences, La Trobe University, Bundoora, Australia
| | - Antony Walton
- Department of Medicine, Monash University, Melbourne, Australia.,Heart Centre, Alfred Hospital, Melbourne, Australia
| | - Elizabeth E Gardiner
- ACRF Department of Cancer Biology and Therapeutics, John Curtin School of Medical Research, Australian National University, Canberra, Australia
| | - Robert K Andrews
- Department of Medicine, Monash University, Melbourne, Australia.,Australian Centre for Blood Diseases, Monash University, Melbourne, Australia
| | - Markus P Schlaich
- Department of Medicine, Monash University, Melbourne, Australia.,Neurovascular Hypertension and Kidney Disease, Baker Heart and Diabetes Institute, Melbourne, Australia.,Dobney Hypertension Centre, School of Medicine, Royal Perth Hospital Unit, University of Western Australia, Perth, Australia.,Heart Centre, Alfred Hospital, Melbourne, Australia
| | - Karlheinz Peter
- Atherothrombosis and Vascular Biology, Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC 3004, Australia.,Department of Medicine, Monash University, Melbourne, Australia.,Heart Centre, Alfred Hospital, Melbourne, Australia
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13
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Gueguen C, Burke SL, Barzel B, Eikelis N, Watson AMD, Jha JC, Jackson KL, Sata Y, Lim K, Lambert GW, Jandeleit-Dahm KAM, Cooper ME, Thomas MC, Head GA. Empagliflozin modulates renal sympathetic and heart rate baroreflexes in a rabbit model of diabetes. Diabetologia 2020; 63:1424-1434. [PMID: 32372207 DOI: 10.1007/s00125-020-05145-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 03/10/2020] [Indexed: 10/24/2022]
Abstract
AIMS/HYPOTHESIS We determined whether empagliflozin altered renal sympathetic nerve activity (RSNA) and baroreflexes in a diabetes model in conscious rabbits. METHODS Diabetes was induced by alloxan, and RSNA, mean arterial pressure (MAP) and heart rate were measured before and after 1 week of treatment with empagliflozin, insulin, the diuretic acetazolamide or the ACE inhibitor perindopril, or no treatment, in conscious rabbits. RESULTS Four weeks after alloxan administration, blood glucose was threefold and MAP 9% higher than non-diabetic controls (p < 0.05). One week of treatment with empagliflozin produced a stable fall in blood glucose (-43%) and increased water intake (+49%) but did not change RSNA, MAP or heart rate compared with untreated diabetic rabbits. The maximum RSNA to hypotension was augmented by 75% (p < 0.01) in diabetic rabbits but the heart rate baroreflex was unaltered. Empagliflozin and acetazolamide reduced the augmentation of the RSNA baroreflex (p < 0.05) to be similar to the non-diabetic group. Noradrenaline (norepinephrine) spillover was similar in untreated diabetic and non-diabetic rabbits but twofold greater in empagliflozin- and acetazolamide-treated rabbits (p < 0.05). CONCLUSIONS/INTERPRETATION As empagliflozin can restore diabetes-induced augmented sympathetic reflexes, this may be beneficial in diabetic patients. A similar action of the diuretic acetazolamide suggests that the mechanism may involve increased sodium and water excretion. Graphical abstract.
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Affiliation(s)
- Cindy Gueguen
- Neuropharmacology Laboratory, Baker Heart and Diabetes Institute, P.O. Box 6492, Melbourne, VIC, 3004, Australia
| | - Sandra L Burke
- Neuropharmacology Laboratory, Baker Heart and Diabetes Institute, P.O. Box 6492, Melbourne, VIC, 3004, Australia
| | - Benjamin Barzel
- Neuropharmacology Laboratory, Baker Heart and Diabetes Institute, P.O. Box 6492, Melbourne, VIC, 3004, Australia
| | - Nina Eikelis
- Iverson Health Innovation Research Institute and School of Health Science, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Anna M D Watson
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Jay C Jha
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Kristy L Jackson
- Neuropharmacology Laboratory, Baker Heart and Diabetes Institute, P.O. Box 6492, Melbourne, VIC, 3004, Australia
| | - Yusuke Sata
- Neuropharmacology Laboratory, Baker Heart and Diabetes Institute, P.O. Box 6492, Melbourne, VIC, 3004, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Kyungjoon Lim
- Neuropharmacology Laboratory, Baker Heart and Diabetes Institute, P.O. Box 6492, Melbourne, VIC, 3004, Australia
- Department of Physiology, Anatomy & Microbiology, La Trobe University, Melbourne, VIC, Australia
| | - Gavin W Lambert
- Iverson Health Innovation Research Institute and School of Health Science, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Karin A M Jandeleit-Dahm
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Diabetic Nephropathy Research Group, Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibnitz Center for Diabetes Research, Heinrich Heine University, Düsseldorf, Germany
| | - Mark E Cooper
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Merlin C Thomas
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Geoffrey A Head
- Neuropharmacology Laboratory, Baker Heart and Diabetes Institute, P.O. Box 6492, Melbourne, VIC, 3004, Australia.
- Department of Pharmacology, Monash University, Melbourne, VIC, Australia.
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15
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Kawada T, Sata Y, Akiyama T, Shimizu S, Sonobe T, Pearson JT, Sugimachi M. Threshold and saturation pressures of baroreflex-mediated myocardial interstitial acetylcholine release in rats. Auton Neurosci 2020; 225:102657. [PMID: 32097880 DOI: 10.1016/j.autneu.2020.102657] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 02/17/2020] [Accepted: 02/18/2020] [Indexed: 10/25/2022]
Abstract
Cardiac microdialysis allows the assessment of cardiac efferent vagal nerve activity from myocardial interstitial acetylcholine (ACh) levels with minimal influence on the neural control of the heart; however, a total picture of the baroreflex-mediated myocardial interstitial ACh release including the threshold and saturation pressures has yet to be quantified. In eight anesthetized Wistar-Kyoto rats, we implanted microdialysis probes in the left ventricular free wall and measured the myocardial interstitial ACh release simultaneously with efferent sympathetic nerve activity (SNA) during a carotid sinus baroreceptor pressure input between 60 and 180 mm Hg. The baroreflex-mediated ACh release approximated a positive sigmoid curve, and its threshold and saturation pressures were not significantly different from those of an inverse sigmoid curve associated with the baroreflex-mediated SNA response (threshold: 94.3 ± 8.6 vs. 99.3 ± 6.0 mm Hg; saturation: 150.0 ± 10.3 vs. 158.8 ± 5.8 mm Hg). The sympathetic and vagal systems have certain levels of activities across most of the normal pressure range.
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Affiliation(s)
- Toru Kawada
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Osaka 564-8565, Japan.
| | - Yusuke Sata
- Human Neurotransmitters Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Tsuyoshi Akiyama
- Department of Cardiac Physiology, National Cerebral and Cardiovascular Center, Osaka 564-8565, Japan
| | - Shuji Shimizu
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Osaka 564-8565, Japan
| | - Takashi Sonobe
- Department of Cardiac Physiology, National Cerebral and Cardiovascular Center, Osaka 564-8565, Japan
| | - James T Pearson
- Department of Cardiac Physiology, National Cerebral and Cardiovascular Center, Osaka 564-8565, Japan
| | - Masaru Sugimachi
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Osaka 564-8565, Japan
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16
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Gueguen C, Burke SL, Barzel B, Lim K, Eikelis N, Watson AM, Jha JC, Jackson KL, Sata Y, Lambert GW, Jandeleit-Dahm KA, Cooper ME, Thomas MC, Head GA. Treatment with SGLT2 Inhibitor Empagliflozin Modulates Renal Sympathetic Nerve Activity in Diabetic Rabbits. FASEB J 2020. [DOI: 10.1096/fasebj.2020.34.s1.04880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | | | | | - Nina Eikelis
- Iverson Health Innovation Research Institute and School of Health Science Swinburne University of Technology
| | | | - Jay C. Jha
- Central Clinical School Monash University
| | | | | | - Gavin W. Lambert
- Iverson Health Innovation Research Institute and School of Health Science Swinburne University of Technology
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Wada H, Toyoda T, Kaiho T, Ohashi K, Shina Y, Sata Y, Hata A, Yamamoto T, Morimoto J, Sakairi Y, Suzuki H, Nakajima T, Yoshino I. P2.16-44 Long-Term Outcome of Pulmonary Segmentectomy for c-IA Non-Small Cell Lung Cancer. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Kaiho T, Suzuki H, Ohashi K, Shiina Y, Sata Y, Toyoda T, Hata A, Yamamoto T, Morimoto J, Sakairi Y, Wada H, Nakajima T, Yoshino I. P1.16-36 Real-Time Ct Guided Video Assisted Thoracoscopic Partial Resection of Peripheral Small-Sized Lung Tumors. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Shiina Y, Nakajima T, Kaiho T, Ohashi K, Sata Y, Hata A, Toyoda T, Yamamoto T, Morimoto J, Sakairi Y, Wada H, Suziki H, Yoshino I. P3.16-09 High Preoperative D-Dimer Level Predicts Early Recurrence After Surgery for Non-Small Cell Lung Cancer. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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20
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Sata Y, Head GA, Esler MD, Schlaich MP. Reply. J Hypertens 2018; 36:1606-1607. [PMID: 29847455 DOI: 10.1097/hjh.0000000000001765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Yusuke Sata
- Neurovascular Hypertension and Kidney Disease Laboratory.,Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria
| | - Geoffrey A Head
- Neuropharmacology Laboratory, Baker Heart and Diabetes Institute
| | - Murray D Esler
- Neurovascular Hypertension and Kidney Disease Laboratory.,Department of Cardiovascular Medicine, Alfred Hospital
| | - Markus P Schlaich
- Neurovascular Hypertension and Kidney Disease Laboratory.,Department of Cardiovascular Medicine, Alfred Hospital.,Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria.,Royal Perth Hospital Unit, Dobney Hypertension Centre, School of Medicine, University of Western Australia, Perth, Western Australia, Australia
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Hata A, Suzuki H, Oeda H, Nishii K, Kaiho T, Ohashi K, Shiina Y, Sata Y, Toyoda T, Sakairi Y, Tamura H, Fujiwara T, Wada H, Nakajima T, Yamada Y, Chiyo M, Yoshino I. Gene Expression Profiling in Murine Orthotopic Lung Transplantation Model of Chronic Lung Allograft Dysfunction (CLAD). J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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22
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Sata Y, Head GA, Denton K, May CN, Schlaich MP. Role of the Sympathetic Nervous System and Its Modulation in Renal Hypertension. Front Med (Lausanne) 2018; 5:82. [PMID: 29651418 PMCID: PMC5884873 DOI: 10.3389/fmed.2018.00082] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 03/15/2018] [Indexed: 12/18/2022] Open
Abstract
The kidneys are densely innervated with renal efferent and afferent nerves to communicate with the central nervous system. Innervation of major structural components of the kidneys, such as blood vessels, tubules, the pelvis, and glomeruli, forms a bidirectional neural network to relay sensory and sympathetic signals to and from the brain. Renal efferent nerves regulate renal blood flow, glomerular filtration rate, tubular reabsorption of sodium and water, as well as release of renin and prostaglandins, all of which contribute to cardiovascular and renal regulation. Renal afferent nerves complete the feedback loop via central autonomic nuclei where the signals are integrated and modulate central sympathetic outflow; thus both types of nerves form integral parts of the self-regulated renorenal reflex loop. Renal sympathetic nerve activity (RSNA) is commonly increased in pathophysiological conditions such as hypertension and chronic- and end-stage renal disease. Increased RSNA raises blood pressure and can contribute to the deterioration of renal function. Attempts have been made to eliminate or interfere with this important link between the brain and the kidneys as a neuromodulatory treatment for these conditions. Catheter-based renal sympathetic denervation has been successfully applied in patients with resistant hypertension and was associated with significant falls in blood pressure and renal protection in most studies performed. The focus of this review is the neural contribution to the control of renal and cardiovascular hemodynamics and renal function in the setting of hypertension and chronic kidney disease, as well as the specific roles of renal efferent and afferent nerves in this scenario and their utility as a therapeutic target.
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Affiliation(s)
- Yusuke Sata
- Neurovascular Hypertension and Kidney Disease Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.,Faculty of Medicine, Nursing and Health Sciences, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Geoffrey A Head
- Neuropharmacology Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Kate Denton
- Cardiovascular Program, Department of Physiology, Monash Biomedicine Discovery Institute, Monash University, Melbourne, VIC, Australia
| | - Clive N May
- Preclinical Critical Care Unit, The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Markus P Schlaich
- Neurovascular Hypertension and Kidney Disease Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.,Faculty of Medicine, Nursing and Health Sciences, Central Clinical School, Monash University, Melbourne, VIC, Australia.,Dobney Hypertension Centre, School of Medicine - Royal Perth Hospital Unit, University of Western Australia, Perth, WA, Australia
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Wada H, Oheda H, Nishii K, Kaiho T, Ohashi K, Shina Y, Sata Y, Toyoda T, Hata A, Sakairi Y, Tamura H, Fujiwara T, Nakajima T, Suzuki H, Chiyo M, Yoshino I. P1.16-008 Near-Infrared Fluorescence-Guided Pulmonary Segmentectomy Following Endobronchial Indocyanine Green Injection. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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24
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Sakairi Y, Nakajima T, Yonemori Y, Kaiho T, Ohashi K, Sata Y, Shiina Y, Toyoda T, Hata A, Tamura H, Fujiwara T, Wada H, Suzuki H, Chiyo M, Yoshino I. P2.12-006 Evaluation of New 25G Needle in EBUS-TBNA Comparing Conventional 22G Needle in Diagnosis for Nodal Metastasis of Lung Cancer. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Affiliation(s)
- Markus P Schlaich
- From the Dobney Hypertension Centre, School of Medicine (M.P.S., O.A.), Department of Cardiology (M.P.S.), and Department of Nephrology (M.P.S.), Royal Perth Hospital Unit, University of Western Australia; and Neurovascular Hypertension & Kidney Disease Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia (M.P.S., Y.S.).
| | - Omar Azzam
- From the Dobney Hypertension Centre, School of Medicine (M.P.S., O.A.), Department of Cardiology (M.P.S.), and Department of Nephrology (M.P.S.), Royal Perth Hospital Unit, University of Western Australia; and Neurovascular Hypertension & Kidney Disease Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia (M.P.S., Y.S.)
| | - Yusuke Sata
- From the Dobney Hypertension Centre, School of Medicine (M.P.S., O.A.), Department of Cardiology (M.P.S.), and Department of Nephrology (M.P.S.), Royal Perth Hospital Unit, University of Western Australia; and Neurovascular Hypertension & Kidney Disease Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia (M.P.S., Y.S.)
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Shimizu S, Akiyama T, Kawada T, Sata Y, Turner MJ, Fukumitsu M, Yamamoto H, Kamiya A, Shishido T, Sugimachi M. Sodium ion transport participates in non-neuronal acetylcholine release in the renal cortex of anesthetized rabbits. J Physiol Sci 2017; 67:587-593. [PMID: 27660058 PMCID: PMC10717196 DOI: 10.1007/s12576-016-0489-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 09/13/2016] [Indexed: 12/12/2022]
Abstract
This study examined the mechanism of release of endogenous acetylcholine (ACh) in rabbit renal cortex by applying a microdialysis technique. In anesthetized rabbits, a microdialysis probe was implanted into the renal cortex and perfused with Ringer's solution containing high potassium concentration, high sodium concentration, a Na+/K+-ATPase inhibitor (ouabain), or an epithelial Na+ channel blocker (benzamil). Dialysate samples were collected at baseline and during exposure to each agent, and ACh concentrations in the samples were measured by high-performance liquid chromatography. High potassium had no effect on renal ACh release. High sodium increased dialysate ACh concentrations significantly. Ouabain increased dialysate ACh concentration significantly. Benzamil decreased dialysate ACh concentrations significantly both at baseline and under high sodium. The finding that high potassium-induced depolarization does not increase ACh release suggests that endogenous ACh is released in renal cortex mainly by non-neuronal mechanism. Sodium ion transport may be involved in the non-neuronal ACh release.
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Affiliation(s)
- Shuji Shimizu
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan.
| | - Tsuyoshi Akiyama
- Department of Cardiac Physiology, National Cerebral and Cardiovascular Center, Osaka, 565-8565, Japan
| | - Toru Kawada
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan
| | - Yusuke Sata
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan
| | - Michael James Turner
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan
| | - Masafumi Fukumitsu
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan
| | - Hiromi Yamamoto
- Division of Cardiology, Department of Medicine, Faculty of Medicine, Kindai University, Osaka, 589-8511, Japan
| | - Atsunori Kamiya
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan
| | - Toshiaki Shishido
- Department of Research Promotion, National Cerebral and Cardiovascular Center, Osaka, 565-8565, Japan
| | - Masaru Sugimachi
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan
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Schlaich MP, Hering D, Sata Y. Renal denervation in less severe forms of (resistant) hypertension-Quo vadis? J Clin Hypertens (Greenwich) 2017; 19:369-370. [PMID: 28383187 DOI: 10.1111/jch.12979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Markus P Schlaich
- Dobney Hypertension Centre, School of Medicine and Pharmacology, Royal Perth Hospital Unit, University of Western Australia, Perth, WA, Australia.,Department of Cardiology, Royal Perth Hospital, Perth, WA, Australia.,Neurovascular Hypertension and Kidney Disease Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Dagmara Hering
- Dobney Hypertension Centre, School of Medicine and Pharmacology, Royal Perth Hospital Unit, University of Western Australia, Perth, WA, Australia
| | - Yusuke Sata
- Neurovascular Hypertension and Kidney Disease Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia
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Lim K, Sata Y, Jackson KL, Burke SL, Head GA. Acute Effect of Central Administration of Urotensin II on Baroreflex and Blood Pressure in Conscious Normotensive Rabbits. Front Physiol 2017; 8:110. [PMID: 28280470 PMCID: PMC5322237 DOI: 10.3389/fphys.2017.00110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 02/09/2017] [Indexed: 12/03/2022] Open
Abstract
In the present study, we examined the effects of central administration of Urotensin II on blood pressure, heart rate, and baroreceptor heart rate reflexes in conscious normotensive rabbits. Preliminary operations were undertaken to implant a balloon cuff on the inferior vena cava for baroreflex assessments and to implant cannula into the lateral and fourth ventricle. After 2 weeks of recovery cumulative dose response curves to Urotensin II (10, 100 ng, 1, 10, and 100 μg) given into the ventricles, or Ringer's solution as a vehicle were performed on separate days. Injections were given each hour and baroreflex assessments were made 30 min after each administration. Analysis of the dose response curves to Urotensin II compared to vehicle administered into the lateral or fourth ventricle, indicated little change to blood pressure or heart rate. Analysis of the time course to the highest dose over a 30 min period revealed a small (−5 mmHg) depressor response maximal at 10 min when injected into the fourth ventricle but no effect when injected into the lateral ventricle. Baroreflex assessments made at each dose showed that there was no change in baroreflex sensitivity but that an increase in the upper plateau was observed when Urotensin was injected into the lateral ventricle and a tendency for a reduced lower heart rate plateau was observed after fourth ventricle administration. Clonidine administration in the fourth ventricle decreased blood pressure and heart rate, thus confirming catheter patency. In conclusion, our findings suggest that Urotensin II in the forebrain and brainstem may play a role in modulating cardiac sympathetic and vagal baroreflexes but only during large acute changes in blood pressure.
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Affiliation(s)
- Kyungjoon Lim
- Department of Neuropharmacology, Baker IDI Heart and Diabetes Research InstituteMelbourne, VIC, Australia; Department of Physiology, Monash UniversityClayton, VIC, Australia
| | - Yusuke Sata
- Department of Neuropharmacology, Baker IDI Heart and Diabetes Research InstituteMelbourne, VIC, Australia; Faculty of Medicine, Nursing and Health Science, Monash UniversityClayton, VIC, Australia
| | - Kristy L Jackson
- Department of Neuropharmacology, Baker IDI Heart and Diabetes Research Institute Melbourne, VIC, Australia
| | - Sandra L Burke
- Department of Neuropharmacology, Baker IDI Heart and Diabetes Research Institute Melbourne, VIC, Australia
| | - Geoffrey A Head
- Department of Neuropharmacology, Baker IDI Heart and Diabetes Research InstituteMelbourne, VIC, Australia; Department of Pharmacology, Monash UniversityClayton, VIC, Australia
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Zaldivia MTK, Rivera J, Hering D, Marusic P, Sata Y, Lim B, Eikelis N, Lee R, Lambert GW, Esler MD, Htun NM, Duval J, Hammond L, Eisenhardt SU, Flierl U, Schlaich MP, Peter K. Renal Denervation Reduces Monocyte Activation and Monocyte-Platelet Aggregate Formation: An Anti-Inflammatory Effect Relevant for Cardiovascular Risk. Hypertension 2016; 69:323-331. [PMID: 27956575 DOI: 10.1161/hypertensionaha.116.08373] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 09/17/2016] [Accepted: 11/16/2016] [Indexed: 02/06/2023]
Abstract
Overactivation of renal sympathetic nervous system and low-grade systemic inflammation are common features of hypertension. Renal denervation (RDN) reduces sympathetic activity in patients with resistant hypertension. However, its effect on systemic inflammation has not been examined. We prospectively investigated the effect of RDN on monocyte activation and inflammation in patients with uncontrolled hypertension scheduled for RDN. Ambulatory blood pressure, monocyte, and monocyte subset activation and inflammatory markers were assessed at baseline, 3 months, and 6 months after procedure in 42 patients. RDN significantly lowered blood pressure at 3 months (150.5±11.2/81.0±11.2 mm Hg to 144.7±11.8/77.9±11.0 mm Hg), which was sustained at 6 months (144.7±13.8/78.6±11.0 mm Hg). Activation status of monocytes significantly decreased at 3 months (P<0.01) and 6 months (P<0.01) after the procedure. In particular, classical monocyte activation was reduced at 6 months (P<0.05). Similarly, we observed a reduction of several inflammatory markers, including monocyte-platelet aggregates (3 months, P<0.01), plasma monocyte chemoattractant protein-1 levels (3 months, P<0.0001; 6 months, P<0.05), interleukin-1β (3 months, P<0.05; 6 months, P<0.05), tumor necrosis factor-α (3 months, P<0.01; 6 months, P<0.05), and interleukin-12 (3 months, P<0.01; 6 months, P<0.05). A positive correlation was observed between muscle sympathetic nerve activity and monocyte activation before and after the procedure. These results indicate that inhibition of sympathetic activity via RDN is associated with a reduction of monocyte activation and other inflammatory markers in hypertensive patients. These findings point to a direct interaction between the inflammatory and sympathetic nervous system, which is of central relevance for the understanding of beneficial cardiovascular effects of RDN.
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Affiliation(s)
- Maria T K Zaldivia
- From the Atherothrombosis and Vascular Biology (M.T.K.Z., J.R., B.L., N.M.H., S.U.E., U.F., K.P.) and Neurovascular Hypertension and Kidney Disease Laboratory (D.H., P.M., Y.S., N.E., R.L., G.W.L., M.D.E., J.D., L.H., M.P.S.), Baker IDI Heart and Diabetes Institute, Melbourne, Australia; Department of Medicine, Monash University, Melbourne (M.T.K.Z., N.M.H., M.P.S., K.P.); Dobney Hypertension Centre, School of Medicine and Pharmacology-Royal Perth Hospital Unit, University of Western Australia, Australia (D.H., P.M., M.P.S.); and Department of Plastic and Hand Surgery, University Medical Centre, Freiburg, Germany (S.U.E.)
| | - Jennifer Rivera
- From the Atherothrombosis and Vascular Biology (M.T.K.Z., J.R., B.L., N.M.H., S.U.E., U.F., K.P.) and Neurovascular Hypertension and Kidney Disease Laboratory (D.H., P.M., Y.S., N.E., R.L., G.W.L., M.D.E., J.D., L.H., M.P.S.), Baker IDI Heart and Diabetes Institute, Melbourne, Australia; Department of Medicine, Monash University, Melbourne (M.T.K.Z., N.M.H., M.P.S., K.P.); Dobney Hypertension Centre, School of Medicine and Pharmacology-Royal Perth Hospital Unit, University of Western Australia, Australia (D.H., P.M., M.P.S.); and Department of Plastic and Hand Surgery, University Medical Centre, Freiburg, Germany (S.U.E.)
| | - Dagmara Hering
- From the Atherothrombosis and Vascular Biology (M.T.K.Z., J.R., B.L., N.M.H., S.U.E., U.F., K.P.) and Neurovascular Hypertension and Kidney Disease Laboratory (D.H., P.M., Y.S., N.E., R.L., G.W.L., M.D.E., J.D., L.H., M.P.S.), Baker IDI Heart and Diabetes Institute, Melbourne, Australia; Department of Medicine, Monash University, Melbourne (M.T.K.Z., N.M.H., M.P.S., K.P.); Dobney Hypertension Centre, School of Medicine and Pharmacology-Royal Perth Hospital Unit, University of Western Australia, Australia (D.H., P.M., M.P.S.); and Department of Plastic and Hand Surgery, University Medical Centre, Freiburg, Germany (S.U.E.)
| | - Petra Marusic
- From the Atherothrombosis and Vascular Biology (M.T.K.Z., J.R., B.L., N.M.H., S.U.E., U.F., K.P.) and Neurovascular Hypertension and Kidney Disease Laboratory (D.H., P.M., Y.S., N.E., R.L., G.W.L., M.D.E., J.D., L.H., M.P.S.), Baker IDI Heart and Diabetes Institute, Melbourne, Australia; Department of Medicine, Monash University, Melbourne (M.T.K.Z., N.M.H., M.P.S., K.P.); Dobney Hypertension Centre, School of Medicine and Pharmacology-Royal Perth Hospital Unit, University of Western Australia, Australia (D.H., P.M., M.P.S.); and Department of Plastic and Hand Surgery, University Medical Centre, Freiburg, Germany (S.U.E.)
| | - Yusuke Sata
- From the Atherothrombosis and Vascular Biology (M.T.K.Z., J.R., B.L., N.M.H., S.U.E., U.F., K.P.) and Neurovascular Hypertension and Kidney Disease Laboratory (D.H., P.M., Y.S., N.E., R.L., G.W.L., M.D.E., J.D., L.H., M.P.S.), Baker IDI Heart and Diabetes Institute, Melbourne, Australia; Department of Medicine, Monash University, Melbourne (M.T.K.Z., N.M.H., M.P.S., K.P.); Dobney Hypertension Centre, School of Medicine and Pharmacology-Royal Perth Hospital Unit, University of Western Australia, Australia (D.H., P.M., M.P.S.); and Department of Plastic and Hand Surgery, University Medical Centre, Freiburg, Germany (S.U.E.)
| | - Bock Lim
- From the Atherothrombosis and Vascular Biology (M.T.K.Z., J.R., B.L., N.M.H., S.U.E., U.F., K.P.) and Neurovascular Hypertension and Kidney Disease Laboratory (D.H., P.M., Y.S., N.E., R.L., G.W.L., M.D.E., J.D., L.H., M.P.S.), Baker IDI Heart and Diabetes Institute, Melbourne, Australia; Department of Medicine, Monash University, Melbourne (M.T.K.Z., N.M.H., M.P.S., K.P.); Dobney Hypertension Centre, School of Medicine and Pharmacology-Royal Perth Hospital Unit, University of Western Australia, Australia (D.H., P.M., M.P.S.); and Department of Plastic and Hand Surgery, University Medical Centre, Freiburg, Germany (S.U.E.)
| | - Nina Eikelis
- From the Atherothrombosis and Vascular Biology (M.T.K.Z., J.R., B.L., N.M.H., S.U.E., U.F., K.P.) and Neurovascular Hypertension and Kidney Disease Laboratory (D.H., P.M., Y.S., N.E., R.L., G.W.L., M.D.E., J.D., L.H., M.P.S.), Baker IDI Heart and Diabetes Institute, Melbourne, Australia; Department of Medicine, Monash University, Melbourne (M.T.K.Z., N.M.H., M.P.S., K.P.); Dobney Hypertension Centre, School of Medicine and Pharmacology-Royal Perth Hospital Unit, University of Western Australia, Australia (D.H., P.M., M.P.S.); and Department of Plastic and Hand Surgery, University Medical Centre, Freiburg, Germany (S.U.E.)
| | - Rebecca Lee
- From the Atherothrombosis and Vascular Biology (M.T.K.Z., J.R., B.L., N.M.H., S.U.E., U.F., K.P.) and Neurovascular Hypertension and Kidney Disease Laboratory (D.H., P.M., Y.S., N.E., R.L., G.W.L., M.D.E., J.D., L.H., M.P.S.), Baker IDI Heart and Diabetes Institute, Melbourne, Australia; Department of Medicine, Monash University, Melbourne (M.T.K.Z., N.M.H., M.P.S., K.P.); Dobney Hypertension Centre, School of Medicine and Pharmacology-Royal Perth Hospital Unit, University of Western Australia, Australia (D.H., P.M., M.P.S.); and Department of Plastic and Hand Surgery, University Medical Centre, Freiburg, Germany (S.U.E.)
| | - Gavin W Lambert
- From the Atherothrombosis and Vascular Biology (M.T.K.Z., J.R., B.L., N.M.H., S.U.E., U.F., K.P.) and Neurovascular Hypertension and Kidney Disease Laboratory (D.H., P.M., Y.S., N.E., R.L., G.W.L., M.D.E., J.D., L.H., M.P.S.), Baker IDI Heart and Diabetes Institute, Melbourne, Australia; Department of Medicine, Monash University, Melbourne (M.T.K.Z., N.M.H., M.P.S., K.P.); Dobney Hypertension Centre, School of Medicine and Pharmacology-Royal Perth Hospital Unit, University of Western Australia, Australia (D.H., P.M., M.P.S.); and Department of Plastic and Hand Surgery, University Medical Centre, Freiburg, Germany (S.U.E.)
| | - Murray D Esler
- From the Atherothrombosis and Vascular Biology (M.T.K.Z., J.R., B.L., N.M.H., S.U.E., U.F., K.P.) and Neurovascular Hypertension and Kidney Disease Laboratory (D.H., P.M., Y.S., N.E., R.L., G.W.L., M.D.E., J.D., L.H., M.P.S.), Baker IDI Heart and Diabetes Institute, Melbourne, Australia; Department of Medicine, Monash University, Melbourne (M.T.K.Z., N.M.H., M.P.S., K.P.); Dobney Hypertension Centre, School of Medicine and Pharmacology-Royal Perth Hospital Unit, University of Western Australia, Australia (D.H., P.M., M.P.S.); and Department of Plastic and Hand Surgery, University Medical Centre, Freiburg, Germany (S.U.E.)
| | - Nay M Htun
- From the Atherothrombosis and Vascular Biology (M.T.K.Z., J.R., B.L., N.M.H., S.U.E., U.F., K.P.) and Neurovascular Hypertension and Kidney Disease Laboratory (D.H., P.M., Y.S., N.E., R.L., G.W.L., M.D.E., J.D., L.H., M.P.S.), Baker IDI Heart and Diabetes Institute, Melbourne, Australia; Department of Medicine, Monash University, Melbourne (M.T.K.Z., N.M.H., M.P.S., K.P.); Dobney Hypertension Centre, School of Medicine and Pharmacology-Royal Perth Hospital Unit, University of Western Australia, Australia (D.H., P.M., M.P.S.); and Department of Plastic and Hand Surgery, University Medical Centre, Freiburg, Germany (S.U.E.)
| | - Jacqueline Duval
- From the Atherothrombosis and Vascular Biology (M.T.K.Z., J.R., B.L., N.M.H., S.U.E., U.F., K.P.) and Neurovascular Hypertension and Kidney Disease Laboratory (D.H., P.M., Y.S., N.E., R.L., G.W.L., M.D.E., J.D., L.H., M.P.S.), Baker IDI Heart and Diabetes Institute, Melbourne, Australia; Department of Medicine, Monash University, Melbourne (M.T.K.Z., N.M.H., M.P.S., K.P.); Dobney Hypertension Centre, School of Medicine and Pharmacology-Royal Perth Hospital Unit, University of Western Australia, Australia (D.H., P.M., M.P.S.); and Department of Plastic and Hand Surgery, University Medical Centre, Freiburg, Germany (S.U.E.)
| | - Louise Hammond
- From the Atherothrombosis and Vascular Biology (M.T.K.Z., J.R., B.L., N.M.H., S.U.E., U.F., K.P.) and Neurovascular Hypertension and Kidney Disease Laboratory (D.H., P.M., Y.S., N.E., R.L., G.W.L., M.D.E., J.D., L.H., M.P.S.), Baker IDI Heart and Diabetes Institute, Melbourne, Australia; Department of Medicine, Monash University, Melbourne (M.T.K.Z., N.M.H., M.P.S., K.P.); Dobney Hypertension Centre, School of Medicine and Pharmacology-Royal Perth Hospital Unit, University of Western Australia, Australia (D.H., P.M., M.P.S.); and Department of Plastic and Hand Surgery, University Medical Centre, Freiburg, Germany (S.U.E.)
| | - Steffen U Eisenhardt
- From the Atherothrombosis and Vascular Biology (M.T.K.Z., J.R., B.L., N.M.H., S.U.E., U.F., K.P.) and Neurovascular Hypertension and Kidney Disease Laboratory (D.H., P.M., Y.S., N.E., R.L., G.W.L., M.D.E., J.D., L.H., M.P.S.), Baker IDI Heart and Diabetes Institute, Melbourne, Australia; Department of Medicine, Monash University, Melbourne (M.T.K.Z., N.M.H., M.P.S., K.P.); Dobney Hypertension Centre, School of Medicine and Pharmacology-Royal Perth Hospital Unit, University of Western Australia, Australia (D.H., P.M., M.P.S.); and Department of Plastic and Hand Surgery, University Medical Centre, Freiburg, Germany (S.U.E.)
| | - Ulrike Flierl
- From the Atherothrombosis and Vascular Biology (M.T.K.Z., J.R., B.L., N.M.H., S.U.E., U.F., K.P.) and Neurovascular Hypertension and Kidney Disease Laboratory (D.H., P.M., Y.S., N.E., R.L., G.W.L., M.D.E., J.D., L.H., M.P.S.), Baker IDI Heart and Diabetes Institute, Melbourne, Australia; Department of Medicine, Monash University, Melbourne (M.T.K.Z., N.M.H., M.P.S., K.P.); Dobney Hypertension Centre, School of Medicine and Pharmacology-Royal Perth Hospital Unit, University of Western Australia, Australia (D.H., P.M., M.P.S.); and Department of Plastic and Hand Surgery, University Medical Centre, Freiburg, Germany (S.U.E.)
| | - Markus P Schlaich
- From the Atherothrombosis and Vascular Biology (M.T.K.Z., J.R., B.L., N.M.H., S.U.E., U.F., K.P.) and Neurovascular Hypertension and Kidney Disease Laboratory (D.H., P.M., Y.S., N.E., R.L., G.W.L., M.D.E., J.D., L.H., M.P.S.), Baker IDI Heart and Diabetes Institute, Melbourne, Australia; Department of Medicine, Monash University, Melbourne (M.T.K.Z., N.M.H., M.P.S., K.P.); Dobney Hypertension Centre, School of Medicine and Pharmacology-Royal Perth Hospital Unit, University of Western Australia, Australia (D.H., P.M., M.P.S.); and Department of Plastic and Hand Surgery, University Medical Centre, Freiburg, Germany (S.U.E.)
| | - Karlheinz Peter
- From the Atherothrombosis and Vascular Biology (M.T.K.Z., J.R., B.L., N.M.H., S.U.E., U.F., K.P.) and Neurovascular Hypertension and Kidney Disease Laboratory (D.H., P.M., Y.S., N.E., R.L., G.W.L., M.D.E., J.D., L.H., M.P.S.), Baker IDI Heart and Diabetes Institute, Melbourne, Australia; Department of Medicine, Monash University, Melbourne (M.T.K.Z., N.M.H., M.P.S., K.P.); Dobney Hypertension Centre, School of Medicine and Pharmacology-Royal Perth Hospital Unit, University of Western Australia, Australia (D.H., P.M., M.P.S.); and Department of Plastic and Hand Surgery, University Medical Centre, Freiburg, Germany (S.U.E.).
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Hering D, Marusic P, Duval J, Sata Y, Esler M, Walton A, Schlaich M. OS 19-01 BLOOD PRESSURE INDEPENDENT EFFECTS OF RENAL DENERVATION ON THE DECLINE OF KIDNEY FUNCTION IN PATIENTS WITH CHRONIC KIDNEY DISEASE. J Hypertens 2016. [DOI: 10.1097/01.hjh.0000500502.77405.dd] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kaiho T, Suzuki H, Sata Y, Hata A, Toyoda T, Inage T, Yamamoto T, Tanaka K, Fujiwara T, Wada H, Nakajima T, Iwata T, Yoshida S, Yoshino I. P-181SURGICAL OUTCOMES OF PULMONARY METASTASIS FROM HEPATO-PANCREATO-BILIARY CARCINOMAS: COMPARISON WITH PULMONARY METASTASIS FROM COLORECTAL CARCINOMAS. Interact Cardiovasc Thorac Surg 2016. [DOI: 10.1093/icvts/ivw260.179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Zaldivia MTK, Rivera J, Hering D, Marusic P, Marusic P, Sata Y, Eikelis N, Lee R, Lambert GW, Htun NM, Duval J, Hammond L, Eisenhardt S, Flierl U, Schlaich M, Peter K. Abstract 114: Renal Denervation Reduces Monocyte Activation: An Anti-inflammatory Effect Relevant for Cardiovascular Risk. Hypertension 2016. [DOI: 10.1161/hyp.68.suppl_1.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
Over-activation of renal sympathetic nervous system and low-grade systemic inflammation are thought to be common features of hypertension. Renal Denervation (RDN) reduces sympathetic activity in patients with resistant hypertension. However, its effect on systemic inflammation has not been investigated.
Aim:
To determine the effect of RDN-induced sympathetic inhibition on monocyte activation and systemic inflammation in hypertensive patients.
Methods:
Peripheral blood was obtained from 42 patients who underwent RDN for uncontrolled blood pressure (BP) at baseline, at 3 months and 6 months post-procedure. Ambulatory BP, overall activation status of monocyte as well as monocyte subsets and inflammatory markers were assessed at each time point.
Results:
RDN significantly lowered 24-hour ambulatory BP at 3 months (150.5/81.0 mmHg to 144.7/77.9 mmHg), which was sustained at 6 months (144.7/78.6 mmHg). The overall monocyte activation was significantly decreased (3 months, 4079.4 MFI to 3182.0 MFI; 6 months, 3457.62 MFI) post-RDN, specifically in the subset of classical monocytes (6 months, 4696.8 MFI to 3958.8 MFI). In line with this, reduction of several inflammatory markers were observed, including monocyte-platelet aggregates at 3 months (34% [680 of 2000 monocyte events] to 11.85% [237 of 2000 monocyte events]) and plasma levels of MCP-1 (3 months, 144.9 pg/ml to 100.1 pg/ml; 6 months, 122.2 pg/ml), IL-1β (3 months, 18.3 pg/ml to 10.8 pg/ml; 6 months, 12.2 pg/ml), TNF-α (3 months, 167.5 pg/ml to 78.4 pg/ml; 6 months, 111.1 pg/ml), IL-12 (3 months, 59.8 pg/ml to 9.9 pg/ml; 6 months, 21.4 pg/ml) and IL-6 (3 months, 2.4 pg/ml to 1.5pg/ml; 6 months, 1.9 pg/ml). A positive correlation was observed between baseline muscle sympathetic nerve activity and monocyte activation (R=0.62) and changes observed at both time points (3 months, R=0.63; 6 months, R=0.88) post-procedure.
Conclusions:
Inhibition of sympathetic activity via RDN is associated with a reduction of monocyte activation and other circulating inflammatory markers in hypertensive patients. These findings point to a direct interaction between the inflammatory and sympathetic nervous system, which is of central relevance for the understanding of beneficial cardiovascular effects of RDN.
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Affiliation(s)
| | - Jennifer Rivera
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia
| | - Dagmara Hering
- Dobney Hypertension Cntr, Sch of Medicine and Pharmacology- Royal Perth Hosp Unit, Univ of Western Australia, Perth, Australia
| | - Petra Marusic
- Dobney Hypertension Cntr, Sch of Medicine and Pharmacology- Royal Perth Hosp Unit, Univ of Western Australia, Perth, Australia
| | - Petra Marusic
- Dobney Hypertension Cntr, Sch of Medicine and Pharmacology- Royal Perth Hosp Unit, Univ of Western Australia, Perth, Australia
| | - Yusuke Sata
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia
| | - Nina Eikelis
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia
| | - Rebecca Lee
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia
| | | | - Nay M. Htun
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia
| | | | - Louise Hammond
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia
| | | | - Ulrike Flierl
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia
| | - Markus Schlaich
- Dobney Hypertension Cntr, Sch of Medicine and Pharmacology- Royal Perth Hosp Unit, Univ of Western Australia, Perth, Australia
| | - Karlheinz Peter
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia
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Nakajima T, Sata Y, Inage T, Fujiwara T, Wada H, Suzuki H, Iwata T, Yoshida S, Yoshino I. F-047SHOULD ADDITIONAL SURGICAL STAGING BE PERFORMED ENSUING A NEGATIVE RESULT BY ENDOBRONCHIAL ULTRASOUND-GUIDED TRANSBRONCHIAL NEEDLE ASPIRATION? Interact Cardiovasc Thorac Surg 2016. [DOI: 10.1093/icvts/ivw260.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Affiliation(s)
- Markus P. Schlaich
- From the Dobney Hypertension Centre, School of Medicine and Pharmacology (M.P.S., D.H.) and Departments of Cardiology and Nephrolgy (M.P.S.), Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia; and Neurovascular Hypertension and Kidney Disease Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia (M.P.S., Y.S.)
| | - Yusuke Sata
- From the Dobney Hypertension Centre, School of Medicine and Pharmacology (M.P.S., D.H.) and Departments of Cardiology and Nephrolgy (M.P.S.), Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia; and Neurovascular Hypertension and Kidney Disease Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia (M.P.S., Y.S.)
| | - Dagmara Hering
- From the Dobney Hypertension Centre, School of Medicine and Pharmacology (M.P.S., D.H.) and Departments of Cardiology and Nephrolgy (M.P.S.), Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia; and Neurovascular Hypertension and Kidney Disease Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia (M.P.S., Y.S.)
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Sata Y, Schlaich MP. The Potential Role of Catheter-Based Renal Sympathetic Denervation in Chronic and End-Stage Kidney Disease. J Cardiovasc Pharmacol Ther 2016; 21:344-52. [PMID: 26740184 DOI: 10.1177/1074248415624156] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 10/19/2015] [Indexed: 11/17/2022]
Abstract
Sympathetic activation is a hallmark of chronic and end-stage renal disease and adversely affects cardiovascular prognosis. Hypertension is present in the vast majority of these patients and plays a key role in the progressive deterioration of renal function and the high rate of cardiovascular events in this patient cohort. Augmentation of renin release, tubular sodium reabsorption, and renal vascular resistance are direct consequences of efferent renal sympathetic nerve stimulation and the major components of neural regulation of renal function. Renal afferent nerve activity directly influences sympathetic outflow to the kidneys and other highly innervated organs involved in blood pressure control via hypothalamic integration. Renal denervation of the kidney has been shown to reduce blood pressure in many experimental models of hypertension. Targeting the renal nerves directly may therefore be specifically useful in patients with chronic and end-stage renal disease. In this review, we will discuss the potential role of catheter-based renal denervation in patients with impaired kidney function and also reflect on the potential impact on other cardiovascular conditions commonly associated with chronic kidney disease such as heart failure and arrhythmias.
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Affiliation(s)
- Yusuke Sata
- Neurovascular Hypertension & Kidney Disease Laboratory, Baker IDI Heart and Diabetes Institute and the Heart Centre, Alfred Hospital, Melbourne, Australia
| | - Markus P Schlaich
- Neurovascular Hypertension & Kidney Disease Laboratory, Baker IDI Heart and Diabetes Institute and the Heart Centre, Alfred Hospital, Melbourne, Australia School of Medicine and Pharmacology-Royal Perth Hospital Unit, University of Western Australia, Perth, Australia
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Schlaich MP, Sata Y, Esler MD. CrossTalk opposing view: Which technique for controlling resistant hypertension? Renal nerve ablation. J Physiol 2015; 592:3937-40. [PMID: 25225252 DOI: 10.1113/jphysiol.2014.270710] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Markus P Schlaich
- Neurovascular Hypertension & Kidney Disease, Baker IDI Heart & Diabetes Institute, Melbourne, Victoria, Australia Department of Cardiovascular Medicine, Alfred Hospital, Melbourne, Victoria, Australia Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Yusuke Sata
- Neurovascular Hypertension & Kidney Disease, Baker IDI Heart & Diabetes Institute, Melbourne, Victoria, Australia
| | - Murray D Esler
- Neurovascular Hypertension & Kidney Disease, Baker IDI Heart & Diabetes Institute, Melbourne, Victoria, Australia Department of Cardiovascular Medicine, Alfred Hospital, Melbourne, Victoria, Australia
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Kawada T, Sata Y, Shimizu S, Turner MJ, Fukumitsu M, Sugimachi M. Effects of tempol on baroreflex neural arc versus peripheral arc in normotensive and spontaneously hypertensive rats. Am J Physiol Regul Integr Comp Physiol 2015; 308:R957-64. [DOI: 10.1152/ajpregu.00525.2014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 03/23/2015] [Indexed: 11/22/2022]
Abstract
Although oxidative redox signaling affects arterial pressure (AP) regulation via modulation of vascular tone and sympathetic nerve activity (SNA), it remains unknown which effect plays a dominant role in the determination of AP in vivo. Open-loop systems analysis of the carotid sinus baroreflex was conducted to separately quantify characteristics of the neural arc from baroreceptor pressure input to SNA and the peripheral arc from SNA to AP in normotensive Wistar-Kyoto (WKY; n = 8) and spontaneously hypertensive rats (SHR; n = 8). Responses in SNA and AP to a staircase-wise increase in carotid sinus pressure were examined before and during intravenous administration of the membrane-permeable superoxide dismutase mimetic tempol (30 mg/kg bolus followed by 30 mg·kg−1·h−1). Two-way ANOVA indicated that tempol significantly decreased the response range of SNA (from 89.1 ± 2.4% to 60.7 ± 2.5% in WKY and from 77.5 ± 3.2% to 56.9 ± 7.3% in SHR, P < 0.001) without affecting the lower plateau of SNA (from 12.5 ± 2.4% to 9.5 ± 2.5% in WKY, and from 28.8 ± 2.8% to 30.4 ± 5.7% in SHR, P = 0.800) in the neural arc. While tempol did not affect the peripheral arc characteristics in WKY, it yielded a downward change in the regression line of AP vs. SNA in SHR. In conclusion, oxidative redox signaling plays an important role, not only in the pathological AP elevation, but also in the baroreflex-mediated physiological AP regulation. The effect of modulating oxidative redox signaling on the peripheral arc contributed to the determination of AP in SHR but not in WKY.
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Affiliation(s)
- Toru Kawada
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Osaka, Japan; and
| | - Yusuke Sata
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Osaka, Japan; and
- Department of Artificial Organ Medicine, Faculty of Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Shuji Shimizu
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Osaka, Japan; and
| | - Michael J. Turner
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Osaka, Japan; and
| | - Masafumi Fukumitsu
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Osaka, Japan; and
- Department of Artificial Organ Medicine, Faculty of Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Masaru Sugimachi
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Osaka, Japan; and
- Department of Artificial Organ Medicine, Faculty of Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
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Head G, Burke S, Rensch L, Sata Y, Lambert G, Denton K, Schlaich M. Role of the Renal Nerves in a Conscious Rabbit Model of Chronic Kidney Disease. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.830.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Geoffrey Head
- NeuropharmacologyBaker IDI Heart and Diabetes InstituteMelbourneVictoriaAustralia
- PharmacologyMonash UniversityClaytonVictoriaAustralia
| | - Sandra Burke
- NeuropharmacologyBaker IDI Heart and Diabetes InstituteMelbourneVictoriaAustralia
| | - Lisa Rensch
- PhysiologyMonash UniversityClaytonVictoriaAustralia
| | - Yusuke Sata
- NeuropharmacologyBaker IDI Heart and Diabetes InstituteMelbourneVictoriaAustralia
| | - Gavin Lambert
- NeuropharmacologyBaker IDI Heart and Diabetes InstituteMelbourneVictoriaAustralia
| | - Kate Denton
- PhysiologyMonash UniversityClaytonVictoriaAustralia
| | - Markus Schlaich
- NeuropharmacologyBaker IDI Heart and Diabetes InstituteMelbourneVictoriaAustralia
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Kawada T, Li M, Sata Y, Zheng C, Turner MJ, Shimizu S, Sugimachi M. Calibration of baroreflex equilibrium diagram based on exogenous pressor agents in chronic heart failure rats. Clin Med Insights Cardiol 2015; 9:1-9. [PMID: 25698884 PMCID: PMC4319654 DOI: 10.4137/cmc.s18759] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 12/15/2014] [Accepted: 12/26/2014] [Indexed: 11/05/2022]
Abstract
A baroreflex equilibrium diagram describes the relation between input pressure and sympathetic nerve activity (SNA) and that between SNA and arterial pressure (AP). To calibrate the SNA axis (abscissa) of the baroreflex equilibrium diagram, the AP response to intravenous bolus injections of phenylephrine (0.2-50 μg/kg) or norepinephrine (NE, 0.02-5 μg/kg) was examined in normal control rats (NC, n = 9) and rats with chronic heart failure (CHF, n = 6). The maximum slope of the dose-effect curve was significantly smaller in the CHF group than in the NC group (57.3 ± 5.2 vs 80.9 ± 6.3 mmHg/decade for phenylephrine, 60.2 ± 7.8 vs 80.4 ± 5.9 mmHg/decade for NE; P < 0.01). The CHF/NC ratio of the maximum slope was used to calibrate SNA. While the calibrated baroreflex equilibrium diagram showed increased maximum SNA and operating-point SNA in CHF rats compared with NC rats, the magnitude of increase was smaller than that expected from the excess plasma NE concentration in CHF rats. Plasma NE concentration in the CHF group could be disproportionally high relative to SNA.
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Affiliation(s)
- Toru Kawada
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Meihua Li
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Yusuke Sata
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Osaka, Japan. ; Department of Artificial Organ Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Can Zheng
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Michael J Turner
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Shuji Shimizu
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Masaru Sugimachi
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, Osaka, Japan. ; Department of Artificial Organ Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
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McLellan AJA, Schlaich MP, Taylor AJ, Prabhu S, Hering D, Hammond L, Marusic P, Duval J, Sata Y, Ellims A, Esler M, Peter K, Shaw J, Walton A, Kalman JM, Kistler PM. Reverse cardiac remodeling after renal denervation: Atrial electrophysiologic and structural changes associated with blood pressure lowering. Heart Rhythm 2015; 12:982-90. [PMID: 25638699 DOI: 10.1016/j.hrthm.2015.01.039] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Indexed: 12/14/2022]
Abstract
BACKGROUND Hypertension is the most common modifiable risk factor associated with atrial fibrillation. OBJECTIVE The purpose of this study was to determine the effects of blood pressure (BP) lowering after renal denervation on atrial electrophysiologic and structural remodeling in humans. METHODS Fourteen patients (mean age 64 ± 9 years, duration of hypertension 16 ± 11 years, on 5 ± 2 antihypertensive medications) with treatment-resistant hypertension underwent baseline 24-hour ambulatory BP monitoring, echocardiography, cardiac magnetic resonance imaging, and electrophysiologic study. Electrophysiologic study included measurements of P-wave duration, effective refractory periods, and conduction times. Electroanatomic mapping of the right atrium was completed using CARTO3 to determine local and regional conduction velocity and tissue voltage. Bilateral renal denervation was performed, and all measurements repeated after 6 months. RESULTS After renal denervation, mean 24-hour BP reduced from 152/84 mm Hg to 141/80 mm Hg at 6-month follow-up (P < .01). Global conduction velocity increased significantly (0.98 ± 0.13 m/s to 1.2 ± 0.16 m/s at 6 months, P < .01), conduction time shortened (32 ± 5 ms to 27 ± 6 ms, P < .01), and complex fractionated activity was reduced (37% ± 14% to 19% ± 12%, P = .02). Changes in conduction velocity correlated positively with changes in 24-hour mean systolic BP (R(2) = 0.55, P = .01). There was a significant reduction in left ventricular mass (139 ± 37 g to 120 ± 29 g, P < .01) and diffuse ventricular fibrosis (T1 partition coefficient 0.39 ± 0.07 to 0.31 ± 0.09, P = .01) on cardiac magnetic resonance imaging. CONCLUSION BP reduction after renal denervation is associated with improvements in regional and global atrial conduction and reductions in ventricular mass and fibrosis. Whether changes in electrical and structural remodeling are solely due to BP lowering or are due in part to intrinsic effects of renal denervation remains to be determined.
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Affiliation(s)
- Alex J A McLellan
- Department of Cardiovascular Medicine, Alfred Hospital, Melbourne, Victoria, Australia; Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia; Cardiology Department, Royal Melbourne Hospital, Victoria, Australia; Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Victoria, Australia
| | - Markus P Schlaich
- Department of Cardiovascular Medicine, Alfred Hospital, Melbourne, Victoria, Australia; Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia; Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia; School of Medicine and Pharmacology-Royal Perth Hospital Campus, University of Western Australia, Perth, Australia
| | - Andrew J Taylor
- Department of Cardiovascular Medicine, Alfred Hospital, Melbourne, Victoria, Australia; Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Sandeep Prabhu
- Department of Cardiovascular Medicine, Alfred Hospital, Melbourne, Victoria, Australia; Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia; Cardiology Department, Royal Melbourne Hospital, Victoria, Australia; Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Victoria, Australia
| | - Dagmara Hering
- Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Louise Hammond
- Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Petra Marusic
- Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Jacqueline Duval
- Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Yusuke Sata
- Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Andris Ellims
- Department of Cardiovascular Medicine, Alfred Hospital, Melbourne, Victoria, Australia; Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Murray Esler
- Department of Cardiovascular Medicine, Alfred Hospital, Melbourne, Victoria, Australia; Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia; Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Karlheinz Peter
- Department of Cardiovascular Medicine, Alfred Hospital, Melbourne, Victoria, Australia; Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - James Shaw
- Department of Cardiovascular Medicine, Alfred Hospital, Melbourne, Victoria, Australia; Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Antony Walton
- Department of Cardiovascular Medicine, Alfred Hospital, Melbourne, Victoria, Australia; Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Jonathan M Kalman
- Cardiology Department, Royal Melbourne Hospital, Victoria, Australia; Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Victoria, Australia
| | - Peter M Kistler
- Department of Cardiovascular Medicine, Alfred Hospital, Melbourne, Victoria, Australia; Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia; Cardiology Department, Royal Melbourne Hospital, Victoria, Australia; Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Victoria, Australia.
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McLellan A, Schlaich M, Taylor A, Prabhu S, Hering D, Hammond L, Marusic P, Duval J, Sata Y, Ellims A, Peter K, Shaw J, Walton A, Kalman J, Kistler P. Reverse cardiac remodelling following renal denervation - atrial electrophysiologic and structural changes associated with blood pressure lowering. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.06.321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Sata Y, Kawada T, Shimizu S, Kamiya A, Akiyama T, Sugimachi M. Predominant role of neural arc in sympathetic baroreflex resetting of spontaneously hypertensive rats. Circ J 2014; 79:592-9. [PMID: 25746544 DOI: 10.1253/circj.cj-14-1013] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND There is ongoing controversy over whether neural or peripheral factors are the predominant cause of hypertension. The closed-loop negative feedback operation of the arterial baroreflex hampers understanding of how arterial pressure (AP) is determined through the interaction between neural and peripheral factors. METHODS AND RESULTS: A novel analysis of an isolated open-loop baroreceptor preparation to examine sympathetic nervous activity (SNA) and AP responses to changes in carotid sinus pressure (CSP) in adult spontaneously hypertensive rats (SHR) and normotensive Wistar Kyoto rats (WKY) was conducted. In the neural arc (CSP-SNA relationship), the midpoint pressure (128.9±3.8 vs. 157.9±8.1 mmHg, P<0.001) and the response range of SNA to CSP (90.5±3.7 vs. 115.4±7.6%/mmHg, P=0.011) were higher in SHR. In the peripheral arc (SNA-AP relationship), slope and intercept did not differ. A baroreflex equilibrium diagram was obtained by depicting neural and peripheral arcs in a pressure-SNA plane with rescaled SNA (% in WKY). The operating-point AP (111.3±4.4 vs. 145.9±5.2 mmHg, P<0.001) and SNA (90.8±3.2 vs. 125.1±6.9% in WKY, P<0.001) were shifted towards a higher level in SHR. CONCLUSIONS The shift of the neural arc towards a higher SNA range indicated a predominant contribution to baroreflex resetting in SHR. Notwithstanding the resetting, the carotid sinus baroreflex in SHR preserved an ability to reduce AP if activated with a high enough pressure.
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Affiliation(s)
- Yusuke Sata
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center; Department of Artificial Organ Medicine, Faculty of Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
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Schlaich MP, Sata Y, Esler MD. Rebuttal from Markus P. Schlaich, Yusuke Sata and Murray D. Esler. J Physiol 2014; 592:3947. [PMID: 25225255 DOI: 10.1113/jphysiol.2014.279729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Markus P Schlaich
- Neurovascular Hypertension & Kidney Disease, Baker IDI Heart & Diabetes Institute, Melbourne, Victoria, Australia Department of Cardiovascular Medicine, Alfred Hospital, Melbourne, Victoria, Australia Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Yusuke Sata
- Neurovascular Hypertension & Kidney Disease, Baker IDI Heart & Diabetes Institute, Melbourne, Victoria, Australia
| | - Murray D Esler
- Neurovascular Hypertension & Kidney Disease, Baker IDI Heart & Diabetes Institute, Melbourne, Victoria, Australia Department of Cardiovascular Medicine, Alfred Hospital, Melbourne, Victoria, Australia
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Zimmet H, Porapakkham P, Porapakkham P, Sata Y, Haas SJ, Itescu S, Forbes A, Krum H. Short- and long-term outcomes of intracoronary and endogenously mobilized bone marrow stem cells in the treatment of ST-segment elevation myocardial infarction: a meta-analysis of randomized control trials. Eur J Heart Fail 2014; 14:91-105. [DOI: 10.1093/eurjhf/hfr148] [Citation(s) in RCA: 100] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Hendrik Zimmet
- Monash Centre of Cardiovascular Research & Education in Therapeutics, Department of Epidemiology & Preventive Medicine; School of Public Health & Preventive Medicine, Monash University; 99 Commercial Rd Melbourne VIC 3004 Australia
| | - Pramote Porapakkham
- Department of Cardiothoracic Surgery; Chest Disease Institute; Nonthaburi Thailand
| | | | - Yusuke Sata
- Department of Cardiovascular Dynamics; National Cerebral and CardioVascular Center Research Institute; Osaka Japan
| | - Steven Joseph Haas
- Monash Centre of Cardiovascular Research & Education in Therapeutics, Department of Epidemiology & Preventive Medicine; School of Public Health & Preventive Medicine, Monash University; 99 Commercial Rd Melbourne VIC 3004 Australia
| | - Silviu Itescu
- Department of Medicine; University of Melbourne, St. Vincent's Hospital; Melbourne Australia
| | - Andrew Forbes
- Monash Centre of Cardiovascular Research & Education in Therapeutics, Department of Epidemiology & Preventive Medicine; School of Public Health & Preventive Medicine, Monash University; 99 Commercial Rd Melbourne VIC 3004 Australia
| | - Henry Krum
- Monash Centre of Cardiovascular Research & Education in Therapeutics, Department of Epidemiology & Preventive Medicine; School of Public Health & Preventive Medicine, Monash University; 99 Commercial Rd Melbourne VIC 3004 Australia
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Shimizu S, Akiyama T, Kawada T, Sata Y, Shishido T, Kamiya A, Sugimachi M. Medetomidine can selectively activate cardiac vagal nerve without vagal activation in gastrointestinal tract. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht307.p575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Takahama H, Takaki H, Sata Y, Sakane K, Ino Y, Noguchi T, Goto Y, Sugimachi M. Exercise-Induced ST Elevation in Patients With Non-Ischemic Dilated Cardiomyopathy and Narrow QRS Complexes. Circ J 2013; 77:1033-9. [DOI: 10.1253/circj.cj-12-0814] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Hiroyuki Takahama
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Hiroshi Takaki
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center Research Institute
| | - Yusuke Sata
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center Research Institute
| | - Kazushi Sakane
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Yasushi Ino
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Teruo Noguchi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Yoichi Goto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Masaru Sugimachi
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center Research Institute
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Kawada T, Akiyama T, Shimizu S, Kamiya A, Uemura K, Sata Y, Shirai M, Sugimachi M. Central vagal activation by alpha(2) -adrenergic stimulation is impaired in spontaneously hypertensive rats. Acta Physiol (Oxf) 2012; 206:72-9. [PMID: 22463699 DOI: 10.1111/j.1748-1716.2012.02439.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Revised: 12/21/2011] [Accepted: 03/22/2012] [Indexed: 11/28/2022]
Abstract
AIM To elucidate the abnormality of vagal control in spontaneously hypertensive rats (SHR) by measuring left ventricular myocardial interstitial acetylcholine (ACh) release in response to α(2) -adrenergic stimulation as an index of in vivo vagal nerve activity. METHODS A cardiac microdialysis technique was applied to the rat left ventricle in vivo, and the effect of α(2) -adrenergic stimulation by medetomidine or electrical vagal nerve stimulation on myocardial interstitial ACh levels was examined in normotensive Wistar-Kyoto rats (WKY) and SHR under anaesthetized conditions. RESULTS Intravenous medetomidine (0.1 mg kg(-1) ) significantly increased the ACh levels in WKY (from 2.4 ± 0.6 to 4.2 ± 1.3 nmol L(-1) , P < 0.05, n = 7) but not in SHR (from 2.5 ± 0.7 to 2.7 ± 0.7 nmol L(-1) , n = 7). In contrast, electrical vagal nerve stimulation increased the ACh levels in both WKY (from 1.0 ± 0.4 to 2.9 ± 0.9 nmol L(-1) , P < 0.001, n = 6) and SHR (from 0.9 ± 0.2 to 2.2 ± 0.4 nmol L(-1) , P < 0.001, n = 6). Intravenous administration of medetomidine (0.1 mg kg(-1) ) did not affect the vagal nerve stimulation-induced ACh release in either WKY or SHR. CONCLUSION Medetomidine-induced central vagal activation was impaired in SHR, whereas peripheral vagal control of ACh release was preserved. In addition to abnormal sympathetic control, vagal control by the central nervous system may be impaired in SHR.
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Affiliation(s)
- T. Kawada
- Department of Cardiovascular Dynamics; National Cerebral and Cardiovascular Center Research Institute; Osaka; Japan
| | - T. Akiyama
- Department of Cardiac Physiology; National Cerebral and Cardiovascular Center Research Institute; Osaka; Japan
| | - S. Shimizu
- Department of Cardiovascular Dynamics; National Cerebral and Cardiovascular Center Research Institute; Osaka; Japan
| | - A. Kamiya
- Department of Cardiovascular Dynamics; National Cerebral and Cardiovascular Center Research Institute; Osaka; Japan
| | - K. Uemura
- Department of Cardiovascular Dynamics; National Cerebral and Cardiovascular Center Research Institute; Osaka; Japan
| | - Y. Sata
- Department of Cardiovascular Dynamics; National Cerebral and Cardiovascular Center Research Institute; Osaka; Japan
| | - M. Shirai
- Department of Cardiac Physiology; National Cerebral and Cardiovascular Center Research Institute; Osaka; Japan
| | - M. Sugimachi
- Department of Cardiovascular Dynamics; National Cerebral and Cardiovascular Center Research Institute; Osaka; Japan
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Kawada T, Shimizu S, Sata Y, Kamiya A, Sunagawa K, Sugimachi M. Consideration on step duration to assess open-loop static characteristics of the carotid sinus baroreflex in rats. Annu Int Conf IEEE Eng Med Biol Soc 2012; 2011:689-92. [PMID: 22254403 DOI: 10.1109/iembs.2011.6090155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The carotid sinus baroreflex is one of the most important negative feedback systems to stabilize arterial pressure. Although static characteristics of the carotid sinus baroreflex can be assessed by using a stepwise input protocol under baroreflex open-loop conditions, the step duration has been determined empirically. In the present study, we examined the effects of different time windows (5-10, 15-20, 25-30, 35-40, 45-50, and 55-60 s) on the static characteristics estimated by using a 60-s stepwise input protocol in 10 anesthetized rats. Based on the results, we compared the static characteristics between actual 60-s and 20-s stepwise input protocols. Most of the parameters of the static characteristics did not differ significantly between the 60-s and 20-s stepwise input protocols, suggesting that the open-loop baroreflex static characteristics can be estimated by using a stepwise input with the step duration as short as 20 s in normal rats.
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Affiliation(s)
- Toru Kawada
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, 565-8565 Osaka, Japan.
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Hopper I, Kemp W, Porapakkham P, Sata Y, Condon E, Skiba M, Farber L, Porapakkham P, Williams TJ, Menahem S, Roberts S, Krum H. Impact of heart failure and changes to volume status on liver stiffness: non-invasive assessment using transient elastography. Eur J Heart Fail 2012; 14:621-7. [PMID: 22523374 DOI: 10.1093/eurjhf/hfs044] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
AIM The impact of cardiac dysfunction on the liver is known as cardiac hepatopathy. In certain instances this can result in significant hepatic fibrosis or cirrhosis. The validity of non-invasive tools to assess hepatic fibrosis, such as FibroScan(®) which measures liver stiffness (LSM), has not been established in this setting. We examined the impact of cardiac dysfunction on LSM using FibroScan(®) and the influence of volume changes on LSM. METHODS AND RESULTS A prospective, cross-sectional study examined the use of FibroScan(®) in subjects with left-sided heart failure (LHF, n = 32), right-sided heart failure (RHF, n = 9), and acute decompensated heart failure (ADHF, n = 8). The impact of volume changes upon LSM was further examined in the ADHF group (pre- and post-diuresis) and in a haemodialysis group (HD, n = 12), pre- and post-ultrafiltration on dialysis. Compared with healthy controls [n = 55, LSM = median 4.4 (25th percentile 3.6, 75th percentile 5.1) kPa], LSM was increased in all the cardiac dysfunction subgroups [LHF, 4.7 (4.0, 8.7) kPa, P = 0.04; RHF, 9.7 (5.0, 10.8) kPa, P < 0.001; ADHF, 11.2 (6.7, 14.3) kPa, P < 0.001]. Alteration in volume status via diuresis did not change the baseline LSM in ADHF [11.2 (6.7, 14.3) to 9.5 (7.3, 21.6) kPa, P > 0.05] with mean diuresis 5051 ± 1585 mL, or ultrafiltration in HD [6.0 (3.6, 5.1) vs. 5.7 (4.8, 7.0) kPa, P > 0.05] with mean diuresis 1962 ± 233 mL. CONCLUSION Our findings support the concept of increased LSM in the cardiac failure population. LSM was not altered to a statistically significant level with acute volume changes.
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Affiliation(s)
- Ingrid Hopper
- Department of Clinical Pharmacology and Therapeutics, The Alfred Center, Melbourne, Australia.
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Nesbitt-Hawes E, Campbell N, Won H, Maley P, Henry A, Abbott J, Potdar N, Mason-Birks S, Elson CJ, Gelbaya TA, Nardo LG, Stavroulis A, Nnoaham K, Hummelshoj L, Zondervan K, Saridogan E, GSWH Consortium WERF, Chamie LP, Soares ACP, Kimati CT, Gomes C, Fettback P, Riboldi M, Serafini P, Lalitkumar S, Menezes J, Evdokia D, Gemzell-Danielsson K, Lalitkumar PGL, Bailey J, Newman TA, Johnston A, Zisimopoulou K, White M, Sadek K, Shreeve N, Macklon N, Cheong Y, Al-Akoum M, Akoum A, Giles J, Garrido N, Vidal C, Mondion M, Gallo C, Ramirez J, Pellicer A, Remohi J, Ghosh S, Chattopadhyay R, Jana S, Goswami SK, Bose G, Chakravarty M, Chowdhuri K, Chakravarty BN, Kendirci Ceviren A, Ozcelik Tanriverdi N, Urfan A, Donmez L, Isikoglu M, Romano A, Schreinemacher MH, Backes WH, Slenter JM, Xanthoulea SA, Delvoux B, van Winden L, Beets-Tan RG, Evers JLH, Dunselman GAJ, Jana SK, Chaudhury K, Chattopadhyay R, Chakravarty BN, Maruyama T, Yamasaki A, Miyazaki K, Arase T, Uchida H, Yoshimura Y, Kaser D, Ginsburg E, Missmer S, Correia K, Racowsky C, Streuli I, Chouzenoux S, de Ziegler D, Chereau C, Weill B, Chapron C, Batteux F, Arianmanesh M, Fowler PA, Al-Gubory KH, Urata Y, Osuga Y, Izumi G, Nagai M, Takamura M, Yamamoto N, Saito A, Hasegawa A, Takemura Y, Harada M, Hirata T, Hirota Y, Yoshino O, Koga K, Taketani Y, Mohebbi A, Janan A, Nasri S, Lakpour MR, Ramazanali F, Moini A, Aflatoonian R, Germeyer A, Novak O, Renke T, Jung M, Jackus J, Toth B, Strowitzki T, Bhattacharya J, Mitra A, Kundu S, Pal M, Kundu A, Gumusel A, Basar M, Yaprak E, Aslan E, Arda O, Ilvan S, Kayisli U, Guzel E, Haouzi D, Monzo C, Lehmann S, Hirtz C, Tiers L, Hamamah S, Choi D, Choi J, Jo M, Lee E, Shen X, Wang BIN, Li X, Tamura I, Maekawa R, Asada H, Tamura H, Sugino N, Tamura H, Tamura I, Maekawa R, Asada H, Sugino N, Liu H, Jiang Y, Chen J, Zhu L, Shen X, Wang B, Yan G, Sun H, Coughlan C, Sinagra M, Ledger W, Li TC, Laird SM, Dafopoulos K, Vrekoussis T, Chalvatzas N, Messini CI, Kalantaridou S, Georgoulias P, Messinis IE, Makrigiannakis A, Xue Q, Xu Y, Zuo WL, Zhang L, Shang J, Zhu SN, Bulun SE, Tomassetti C, Geysenbergh B, Meuleman C, Fieuws S, D'Hooghe T, Suginami K, Sato Y, Horie A, Matsumoto H, Fujiwara H, Konishi I, Jung Y, Cho S, Choi Y, Lee B, Seo S, Urman B, Yakin K, Oktem O, Alper E, Taskiran C, Aksoy S, Takeuchi K, Kurematsu T, Yu-ki Y, Fukumoto Y, Homan Y, Sata Y, Kuroki Y, Takeuchi M, Awata S, Muneyyirci-Delale O, Charles C, Anopa J, Osei-Tutu N, Dalloul M, Weedon J, Muney A, Stratton P, Yilmaz B, Kilic S, Aksakal O, Kelekci S, Aksoy Y, Lordlar N, Sut N, Gungor T, Chan J, Tan CW, Lee YH, Tan HH, Choolani M, Griffith L, Oldeweme J, Barcena de Arellano ML, Reichelt U, Schneider A, Mechsner S, Barcena de Arellano ML, Munch S, Vercellino GF, Chiantera V, Schneider A, Mechsner S, Santoro L, D'Onofrio F, Campo S, Ferraro PM, Tondi P, Gasbarrini A, Santoliquido A, Jung MH, Kim HY, Barcena de Arellano ML, Arnold J, Vercellino GF, Chiantera V, Schneider A, Mechsner S, Arnold J, Barcena de Arellano ML, Buttner A, Vercellino GF, Chiantera V, Schneider A, Mechsner S, Karaer A, Celik O, Bay Karabulut A, Celik E, Kiran TR, Simsek OY, Yilmaz E, Turkcuoglu I, Tanrikut E, Alieva K, Kulakova E, Ipatova M, Smolnikova V, Kalinina E. ENDOMETRIOSIS, ENDOMETRIUM, IMPLANTATION AND FALLOPIAN TUBE. Hum Reprod 2012. [DOI: 10.1093/humrep/27.s2.78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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