Why the study?
Does unilateral renal impairment with mild renal insufficiency increase atrial fibrillation vulnerability in a canine model?
Does unilateral renal impairment with mild renal insufficiency increase atrial fibrillation vulnerability in a canine model?
A canine model demonstrates that mild renal insufficiency induced by unilateral renal artery embolization increases vulnerability to atrial fibrillation, associated with RAAS activation and atrial fibrosis.
Supports renal-AF link via RAAS/fibrosis in canines; hypothesis-generating and leaves open human translation.
BACKGROUND: Chronic kidney disease and occurrence of atrial fibrillation (AF) are closely related. No studies have examined whether renal impairment (RI) without severe renal dysfunction is associated with the occurrence of AF. METHODS: Unilateral RI with mild renal insufficiency was induced in beagles by embolization of small branches of the renal artery in the left kidney for 2 weeks using gelatin sponge granules in the model group (n = 5). The sham group (n = 5) underwent the same procedure, except for embolization. Parameters associated with RI and renal function were tested, cardiac electrophysiological parameters, blood pressure, left ventricular pressure, and AF vulnerability were investigated. The activity of the sympathetic nervous system, renin-angiotensin-aldosterone system, inflammation, and oxidative stress were measured. Histological studies associated with atrial interstitial fibrosis were performed. RESULTS: Embolization of small branches of the renal artery in the left kidney led to ischemic RI with mild renal insufficiency. The following changes occurred after embolization. Heart rate and P wave duration were increased. Blood pressure and left ventricular systolic pressure were elevated. The atrial effective refractory period and antegrade Wenckebach point were shortened. Episodes and duration of AF, as well as atrial and ventricular rate during AF were increased in the model group. Plasma levels of norepinephrine, renin, and aldosterone were increased, angiotensin II and aldosterone levels in atrial tissue were elevated, and atrial interstitial fibrosis was enhanced after 2 weeks of embolization in the model group. CONCLUSIONS: We successfully established a model of RI with mild renal insufficiency in a large animal. We found that RI with mild renal insufficiency was associated with AF in this model.
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Liang et al. (2014) studied this question.
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