Abstract
ObjectiveTo elucidate the effect of diabetes mellitus (DM) on the atherosclerotic process in saphenous vein grafts by determining urotensin-II (U-II) levels in harvested saphenous veins of patients who underwent coronary artery bypass grafting (CABG).MethodsCoronary artery disease (CAD) patients who underwent CABG were divided into two groups: Group I (eight non-diabetic patients; CAD group) and Group II (13 patients; DM+CAD group). All patients underwent coronary angiography prior to surgery and Gensini score was used to determine the severity of coronary atherosclerosis. Saphenous vein samples were stained with hematoxylin-eosin and U-II, then damage score, H-Score, and vein layer thicknesses were calculated and statistically evaluated.ResultsIn light microscopic evaluation, significant difference was observed between the groups in terms of endothelial cells damage, internal elastic lamina degradation, and tunica media vascular smooth muscle cells (VSMCs) damage (P<0.001). U-II immunoreactivity was increased in tunica adventitia in the DM+CAD group (P=0.002). The increase in foam cells was directly proportional to the thickening of the subendothelial layer, and this increased U-II immunoreactivity. Gensini score was higher in the DM+CAD group than in the CAD group (P=0.002).ConclusionOur results show that saphenous vein grafts are already atherosclerotic before they are grafted in CAD patients. This disease is more severe in diabetic CAD patients and these changes can be detected using U-II immunoreactivity.
Highlights
The saphenous vein is the most commonly used graft for myocardial revascularization because of its large diameter, anatomically long course, absence of spasms, and ease of removal[1,2]
Our results show that saphenous vein grafts are already atherosclerotic before they are grafted in Coronary artery disease (CAD) patients
This disease is more severe in diabetic CAD patients and these changes can be detected using U-II immunoreactivity
Summary
The saphenous vein is the most commonly used graft for myocardial revascularization because of its large diameter, anatomically long course, absence of spasms, and ease of removal[1,2]. 10% to 20% of saphenous vein grafts fail within one year after coronary artery bypass grafting (CABG)[3]. Saphenous vein graft disease (SVGD) significantly affects the short and longterm results of CABG and increases the frequency of major adverse cardiovascular events. It has been shown that many inflammatory and growth factors are secreted from the damaged endothelium in SVGD. These increase the proliferation and migration of smooth muscles in the vascular wall, causing restenosis[4].
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call