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Updated: Jun 5, 2026
A Modified Two Kidney One Clip Mouse Model of Renin Regulation in Renal Artery Stenosis
Published on: October 26, 2020
Reversal of experimental renovascular hypertension restores coronary microvascular function and architecture
Victor H Urbieta-Caceres1, Xiang-Yang Zhu, Matthew E Gibson
1Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Insights
Percutaneous transluminal renal angioplasty (PTRA) successfully reversed hypertension-induced cardiac changes in pigs. Blood pressure normalization improved coronary microvascular function and reduced inflammation, preserving cardiovascular health.
Area of Science:
- Cardiovascular Medicine
- Nephrology
- Medical Imaging
Background:
- Hypertension (HTN) contributes to left ventricular hypertrophy and vascular dysfunction, increasing cardiovascular risk.
- Coronary microvascular dysfunction is a key factor in adverse cardiovascular outcomes.
- Percutaneous transluminal renal angioplasty (PTRA) is a potential intervention for renovascular hypertension.
Purpose of the Study:
- To investigate the effects of PTRA on coronary microvascular function and cardiac structure in a renovascular hypertension model.
- To assess the impact of blood pressure reduction on myocardial inflammation and fibrosis.
- To evaluate the restoration of microvascular architecture and function following PTRA.
Main Methods:
- A renovascular hypertension model was established in pigs using a renal artery coil.
- Pigs underwent PTRA or sham procedures after 6 weeks of hypertension.
- Multidetector-computed tomography (CT) assessed cardiac and microvascular function; cardiac tissue analysis explored inflammation and fibrosis.
Main Results:
- PTRA effectively lowered blood pressure and reduced left ventricular hypertrophy.
- Coronary microvascular function, including response to adenosine, was restored by PTRA.
- PTRA reversed hypertension-associated increases in inflammation and microvascular remodeling, though fibrosis reduction was partial.
Conclusions:
- Reversal of early renovascular hypertension via PTRA improves coronary microvascular function and cardiac structure.
- Blood pressure normalization is crucial for preserving cardiovascular function and structure.
- PTRA demonstrates significant benefits in mitigating hypertension-related cardiovascular damage.
Background:
Hypertension (HTN) may lead to left ventricular hypertrophy and vascular dysfunction, which are independent factors for adverse cardiovascular outcomes. We hypothesized that decreased blood pressure by percutaneous transluminal renal angioplasty (PTRA) would improve the function and architecture of coronary microvessels, in association with decreased inflammation and fibrosis.
Methods:
Three groups of pigs were studied: normal, HTN, and HTN+PTRA. After 6 weeks of renovascular HTN, induced by placing a local-irritant coil in the renal artery, pigs underwent PTRA or sham. Four weeks later multidetector-computed tomography (CT) was used to assess systolic, diastolic, and microvascular function, and responses to adenosine. Microvascular architecture, oxygen sensors, inflammation, and fibrosis were then explored in cardiac tissue.
Results:
PTRA successfully decreased blood pressure and left ventricular hypertrophy. Basal fractional vascular volume (FVV) was similar among the groups, but its response to adenosine was significantly attenuated in HTN, whereas microvascular permeability (MP) and response to adenosine were greater than normal. Both were restored by PTRA. These were accompanied by increased myocardial expression of hypoxia-inducible factor (HIF)-1α, inflammation, and microvascular remodeling, including increased density of epicardial microvessels (20-200 µm), as well as cardiac diastolic dysfunction, all of which improved by reversal of HTN. However, PTRA only partially decreased myocardial fibrosis.
Conclusions:
Reversal of early renovascular HTN improved coronary microvascular function and architecture and reversed myocardial hypertrophy and diastolic dysfunction, in association with decreased levels of myocardial ischemia and inflammation markers, underscoring the benefits of blood pressure normalization for preservation of cardiovascular function and structure.
