Abstract
The vascular endothelial growth factor (VEGF) family of peptides and caveolins (CAVs) are reported to contribute, in early graft failure in patients, a coronary artery bypass grafting (CABG). To investigate the possible association of ultimate luminal occlusion to VEGFs and CAVs expression, a functional analysis (based on the molecular biology, bioinformatics, histology, and clinical studies) was performed. Twenty-four hundred and sixty-eight CABG patients diagnosed with multivessel stable coronary artery disease (CAD) were enrolled into prospective study and assigned to two subgroups: double- and triple-vessel CAD subjects. Distal parts of all the harvested saphenous vein (SV) and internal thoracic artery (ITA) segments were used for further tests. ITA graft failure did not differ between double-vessel and triple-vessel CAD patients. The number of SV occlusions was significantly higher in triple-vessel CAD subjects. The microarray analysis performed on SV and ITA samples obtained exclusively from triple-vessel CAD patients who developed early graft occlusion revealed 383 genes with increased and 301 genes with decreased expression in ITA samples as compared to SV grafts. This was followed by functional analysis of ‘blood vessel development’ group of genes. Average VEGF-C expression in ITA grafts was higher than in corresponding SV grafts; FLT4 expression was significantly higher in SV than in ITA transplants. VEGFR-3 and CAV3 expression demonstrated immunohistochemically in SMCs of the tunica media of SV grafts predicted their early restenosis in triple-vessel CAD patients. CAV2 protein expression in SMCs of ITA grafts indicated the risk of early graft failure both in double-vessel and triple-vessel CAD subjects.
Highlights
Vascular restenosis is a common adverse event following coronary artery bypass grafting (CABG) [1]
The basic rationale for the present research was to optimize the clinical protocol of control examinations of the patients who have undergone CABG
We do realize that evaluation of all the CABG patients after surgery via computed tomography (CT) is uneconomical
Summary
Vascular restenosis is a common adverse event following coronary artery bypass grafting (CABG) [1]. The long-term VEGF activity in vascular grafts might result in smooth muscle cells (SMCs) proliferation and/or neointimal formation. Several prospective studies have been performed so far They focused on the determination of ECs markers [9, 10], immune cells infiltration [11], or caveolin (CAV) expression [12, 13]. There are no complex studies involving the use of microarray tools in determining the possible role of ‘blood vessel development’ group of genes in the long-term patency rate of vascular grafts. In line with the information presented above, the present report, based on a combination of molecular, bioinformatics, histological, and clinical studies, seeks to define the actual significance of the VEGF and CAV families of peptides in vascular grafts restenosis
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