Specific Afferent Renal Denervation Improves Reduced nNOS in the Paraventricular Nucleus in Rats with Heart Failure

Abstract

Renal denervation (RDN) has been shown to restore endogenous neuronal nitric oxide synthase (nNOS) in the paraventricular nucleus (PVN), and at the same time reduce sympathetic drive during heart failure (HF), however the role of afferent versus efferent renal nerves in this response remains to be determined. The purpose of the present study was to assess the contribution of afferent renal nerves (ARN) in the nNOS within the PVN mediated sympathetic outflow in rats with HF. HF was induced in rats by ligation of the left coronary artery. Four weeks after surgery, selective afferent RDN (A‐RDN) was performed by bilateral perivascular application of capsaicin on the renal arteries. Seven days after intervention, A‐RDN was verified by lack of calcitonin gene‐related peptide in renal pelvic wall. A‐RDN reduced basal lumbar sympathetic nerve activity (LSNA) in rats with HF (8.5 ± 0.5 vs 17.0 ± 1.2 % of Max). nNOS‐positive cells immunostaining and ‐diaphorase staining were significantly decreased in the PVN of HF rats, findings that were ameliorated by A‐RDN. Microinjection of nNOS inhibitor L‐NMMA into the PVN resulted in a blunted increase in LSNA in HF, this response was improved after A‐RDN (ΔLSNA: 25.7 ± 2.4 vs 11.2 ± 0.9%). Resting ARN activity, expressed as a percent of peak ARN activity, was substantially increased in HF compared to sham rats (60.9 ± 2.2 vs 27.7 ± 4.4 %Amax). These results suggest that intact ARN contribute to the reduction of nNOS in the PVN, resulting in activation of the neurons in the PVN of rats with HF. Specific A‐RDN restores nNOS and thus attenuates the sympathoexcitation. Also, resting ARN activity is elevated in HF rats, which may highlight a crucial neural mechanism initiated from the kidney in the maintenance of enhanced sympathetic drive in HF.Support or Funding InformationThis work was supported by NIH grant P01 HL62222.