{
    "abstract": "The use of circulatory assist devices has been shown to improve glomerular filtration rate and reduce the incidence of acute kidney injury in patients following acute cardiac pathology. However, the mechanisms of improvement in kidney function are not clear. We tested the hypothesis that mechanical circulatory support would result in a decrease in directly recorded renal sympathetic nerve activity (RSNA) and mediate the improvement in renal blood flow (RBF) in a setting of acute myocardial infarction (AMI)-induced left ventricular systolic dysfunction.\nAn anaesthetized ovine model was used to induce AMI (n\u2009=\u20098) using injections of microspheres into the left coronary artery in one group. The second group did not undergo embolization (n\u2009=\u20096). The effects of mechanical circulatory support using the Impella CP on directly recorded renal sympathetic nerve activity were examined in these two groups of animals.\nInjection of microspheres resulted in a drop in mean arterial pressure (MAP) of 21\u2009\u00b1\u20094\u00a0mmHg compared to baseline values (p\u2009<\u20090.05; n\u2009=\u20098). This was associated with a 67% increase in renal sympathetic nerve activity (RSNA; from 16\u2009\u00b1\u20095 to 21\u2009\u00b1\u20095 spikes/s; p\u2009<\u20090.05; n\u2009=\u20097). Impella CP support significantly increased MAP by 13\u2009\u00b1\u20091.5\u00a0mmHg at pump level 8 (p\u2009<\u20090.05) in the AMI group. Incremental pump support resulted in a significant decrease in RSNA (p\u2009<\u20090.05) in both groups. At pump level P8\u00a0in the AMI group, RSNA was decreased by 21\u2009\u00b1\u20095.5% compared to pump level P0 when the pump was not on.\nOur data indicate that the improvement in kidney function following mechanical circulatory support may be mediated in part by renal sympathoinhibition.",
    "authors": [
        {
            "affiliation": "Manaaki Manawa - The Centre for Heart Research and the Department of Physiology, University of Auckland, New Zealand, Auckland, New Zealand.\nDepartment of Physiology, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka.",
            "firstname": "Tania",
            "initials": "T",
            "lastname": "Warnakulasuriya"
        },
        {
            "affiliation": "Manaaki Manawa - The Centre for Heart Research and the Department of Physiology, University of Auckland, New Zealand, Auckland, New Zealand.",
            "firstname": "Bindu",
            "initials": "B",
            "lastname": "George"
        },
        {
            "affiliation": "Auckland District Health Board: Te Whatu Ora Health New Zealand Te Toka Tumai Auckland, Auckland, New Zealand.",
            "firstname": "Nigel",
            "initials": "N",
            "lastname": "Lever"
        },
        {
            "affiliation": "Manaaki Manawa - The Centre for Heart Research and the Department of Physiology, University of Auckland, New Zealand, Auckland, New Zealand. r.ramchandra@auckland.ac.nz.",
            "firstname": "Rohit",
            "initials": "R",
            "lastname": "Ramchandra"
        }
    ],
    "conclusions": "Our data indicate that the improvement in kidney function following mechanical circulatory support may be mediated in part by renal sympathoinhibition.",
    "copyrights": "\u00a9 2024. The Author(s).",
    "doi": "10.1007/s10286-024-01086-5",
    "journal": "Clinical autonomic research : official journal of the Clinical Autonomic Research Society",
    "keywords": [
        "Acute myocardial infarction",
        "LVAD",
        "Mechanical circulatory support",
        "RSNA"
    ],
    "methods": null,
    "publication_date": "2024-11-27",
    "pubmed_id": "39601940\n26796195\n29266676\n18325447\n34447992\n34537309\n4194504\n29349645\n28073804\n31355987\n36431294\n35365048\n33566672\n35762481\n35103864\n14751846\n8304550\n22824986\n18001394\n26670067\n32188462\n35484492\n29514806\n269762\n9258867\n28591467\n11884269\n34436230\n31246097\n18775498\n17002675\n8583823\n5575376\n2735443\n26510698\n23250982\n28960633\n30770052\n35330795\n12406155\n21934091",
    "results": "Injection of microspheres resulted in a drop in mean arterial pressure (MAP) of 21\u2009\u00b1\u20094\u00a0mmHg compared to baseline values (p\u2009<\u20090.05; n\u2009=\u20098). This was associated with a 67% increase in renal sympathetic nerve activity (RSNA; from 16\u2009\u00b1\u20095 to 21\u2009\u00b1\u20095 spikes/s; p\u2009<\u20090.05; n\u2009=\u20097). Impella CP support significantly increased MAP by 13\u2009\u00b1\u20091.5\u00a0mmHg at pump level 8 (p\u2009<\u20090.05) in the AMI group. Incremental pump support resulted in a significant decrease in RSNA (p\u2009<\u20090.05) in both groups. At pump level P8\u00a0in the AMI group, RSNA was decreased by 21\u2009\u00b1\u20095.5% compared to pump level P0 when the pump was not on.",
    "title": "Mechanical circulatory support reduces renal sympathetic nerve activity in an ovine model of acute myocardial infarction.",
    "xml": "<Element 'PubmedArticle' at 0x7885063ab1f0>"
}