Eplerenone inhibites atrial autonomic nerve remodeling via the ERK1/2 MAPK pathway in a rabbit model of atrial fibrillation

Abstract Aims:Aldosterone is closely associated with atrial fibrillation, and mineralocorticoid receptor antagonists (MRAs) have been proved to be effective in preventing atrial structural remodeling. Atrial autonomic nerve system (ANS) plays an important role in atrial fibrillation (AF). However, the effects of MRAs on ANS remodeling in AF and the underlying mechanisms are still unknown.Main methods:Twenty-one rabbits were randomized into sham, pacing(P), and pacing + eplerenone(P + E) groups. HL-1 cells were subject to control treatment or rapid pacing with or without eplerenone or U0126 (an inhibitor of ERK1/2). Atrial sympathetic and parasympathetic remodeling was detected by immunohistohistochemical analysis, western blotting and reverse transcription-polymerase chain reaction. Circulating neurohormone levels and atrial electrophysiology were also assessed.Key findings:The ERK1/2 MAPK pathway was significantly activated in AF rabbit/HL-1 cell models, resulting in the upregulation of key downstream proteins; this effect was significantly restored by eplerenone(P<0.05). Eplerenone also prevented the changes in circulating neurohormone levels, reduced the mRNA levels of sympathetic- and parasympathetic-related growth factors, and inhibited the inducibility and duration of AF.Significance:Eplerenone inhibited atrial autonomic nerve remodeling and the occurrence of AF by modulating the ERK1/2 MAPK pathway.

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Cardiac autonomic nerve system and epicardial fat in atrial fibrillation

International Journal of Cardiology ◽

10.1016/j.ijcard.2019.12.033 ◽

2020 ◽

Vol 303 ◽

pp. 58-59 ◽

Cited By ~ 2

Author(s):

Lei Zhao ◽

Paul A. Gould ◽

Arnold C.T. Ng ◽

William Y.S. Wang

Keyword(s):

Atrial Fibrillation ◽

Epicardial Fat ◽

Autonomic Nerve ◽

Autonomic Nerve System ◽

Nerve System

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A Concise Paradigm on Radical Hysterectomy: The Comprehensive Anatomy of Parametrium, Paracolpium and the Pelvic Autonomic Nerve System and Its Surgical Implication

Cancers ◽

10.3390/cancers12071839 ◽

2020 ◽

Vol 12 (7) ◽

pp. 1839 ◽

Cited By ~ 1

Author(s):

Mustafa Zelal Muallem ◽

Thomas Jöns ◽

Nadja Seidel ◽

Jalid Sehouli ◽

Yasser Diab ◽

...

Keyword(s):

Radical Hysterectomy ◽

Three Dimensional ◽

Figo Stage ◽

Autonomic Nerve ◽

Nerve Sparing ◽

Anatomical Structures ◽

Pelvic Autonomic Nerve ◽

Direct Infiltration ◽

Autonomic Nerve System ◽

Nerve System

The current understanding of radical hysterectomy is more centered on the uterus and little is discussed regarding the resection of the vaginal cuff and the paracolpium as an essential part of this procedure. The anatomic dissections of two fresh and 17 formalin-fixed female pelvis cadavers were utilized to understand and decipher the anatomy of the pelvic autonomic nerve system (PANS) and its connections to the surrounding anatomical structures, especially the paracolpium. The study mandates the recognition of the three-dimensional (3D) anatomic template of the parametrium and paracolpium and provides herewith an enhanced scope during a nerve-sparing radical hysterectomy procedure by precise description of the paracolpium and its close anatomical relationships to the components of the PANS. This enables the medical fraternity to distinguish between direct infiltration of the paracolpium, where the nerve sparing technique is no longer possible, and the affected lymph node in the paracolpium, where nerve sparing is still an option. This study gives rise to a tailored surgical option that allows for abandoning the resection of the paracolpium by FIGO stage IB1, where less than 2 cm vaginal vault resection is demanded.

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