The research group of Professor Hiroaki Shimokawa, Department of Cardiovascular Medicine, Graduate School of Medicine, Tohoku University, is effective in removing the sympathetic nerves of the renal arteries with a catheter for the coronary spasm reaction that occurs near the treated area after coronary stent treatment. I reported something for the first time in the world.
Currently, coronary stent placement treatment using a catheter is being performed for ischemic heart diseases such as angina pectoris and myocardial infarction caused by hardening of the heart artery (coronary artery).This treatment mainly uses drug-eluting stents to prevent restenosis of the blood vessels at the treatment site, but after several years, coronary spasm may occur at both ends of the stent, resulting in chest pain and, in some cases, sudden death. There is a point.
This time, a drug-eluting stent was placed in the coronary artery of the pig.Similar to humans, the occurrence of coronary spasm and an increase in sympathetic nerve fibers were observed at both ends of the stent placement site, indicating that abnormalities in the autonomic nervous system are involved in coronary spasm after stent placement.
Next, renal artery sympathetic denervation (nerve transection around the renal artery), which has the effect of improving the autonomic balance of the whole body, was performed, and the effect on the coronary spasm reaction that occurred after drug-eluting stent placement was evaluated.As a result, it was confirmed by the evaluation of nerve activity using blood pressure and electromyogram that the balance of the autonomic nerves of the whole body was changed by the renal artery sympathetic nerve denervation treatment.Furthermore, it was shown that the increase of sympathetic nerve fibers in the stented coronary artery was suppressed, and it was finally proved that the coronary spasm reaction was suppressed.
This time, we have shown for the first time in the world that renal artery sympathetic denervation treatment can be a treatment method for coronary spasm after stent placement through a multi-organ link called "kidney-brain-heart".In the future, it is expected that the pathophysiology of coronary spasm and general coronary spasm after stent placement will be elucidated, new treatment methods will be established, and the relationship between multiple organs will be elucidated.
Paper Information: [Arteriosclerosis, Thrombosis, and Vascular Biology] Renal Denervation Suppresses Coronary Hyperconstricting Responses after DrugEluting Stent Implantation in Pigs in Vivo through the Kidney-Brain-Heart Axis
