Abstract
Autologous saphenous veins are the most commonly used conduits in revascularization of the ischemic heart by coronary artery bypass graft surgery, but are subject to vein graft failure. The current mini review aims to provide an overview of the role of mechanotransduction signalling underlying vein graft failure to further our understanding of the disease progression and to improve future clinical treatment. Firstly, limitation of damage during vein harvest and engraftment can improve outcome. In addition, cell cycle inhibition, stimulation of Nur77 and external grafting could form interesting therapeutic options. Moreover, the Hippo pathway, with the YAP/TAZ complex as the main effector, is emerging as an important node controlling conversion of mechanical signals into cellular responses. This includes endothelial cell inflammation, smooth muscle cell proliferation/migration, and monocyte attachment/infiltration. The combined effects of expression levels and nuclear/cytoplasmic translocation make YAP/TAZ interesting novel targets in the prevention and treatment of vein graft disease. Pharmacological, molecular and/or mechanical conditioning of saphenous vein segments between harvest and grafting may potentiate targeted and specific treatment to improve long-term outcome.
Highlights
Autologous saphenous veins (SVs) are the most commonly used conduits in revascularization of the ischemic heart by coronary artery bypass graft surgery (CABG), due to their availability, accessibility for harvesting and easy handling when making anastomoses
Blood vessels are exposed to several mechanical stimuli simultaneously, including shear stress on endothelial cells (ECs), luminal pressure and circumferential stretch, both of which exert their effect mainly on smooth muscle cells (SMCs), and longitudinal stretch
The current review aims to provide an overview of the role of the mechanobiology underlying VGD, with a focus on pathways participating in detection of physiologic and pathologic mechanical stress, in an attempt to further our understanding of the disease progression and to improve future clinical treatment
Summary
Cardiovascular Tissue Engineering Unit, Centro Cardiologico Monzino (IRCCS), Milan, Italy. India Xuechong Hong, Boston Children's Hospital, Harvard University, United States. The Hippo pathway, with the YAP/TAZ complex as the main effector, is emerging as an important node controlling conversion of mechanical signals into cellular responses. This includes endothelial cell inflammation, smooth muscle cell proliferation/ migration, and monocyte attachment/infiltration. The combined effects of expression levels and nuclear/cytoplasmic translocation make YAP/TAZ interesting novel targets in the prevention and treatment of vein graft disease. Pharmacological, molecular and/or mechanical conditioning of saphenous vein segments between harvest and grafting may potentiate targeted and specific treatment to improve long-term outcome
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