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The Journal of Cardiovascular Surgery 2003 October;44(5):577-82

language: English

Apoptotic cell death and genetic control in graft coronary artery disease in heart transplant

Di Stefano S. 1, Pardo J. 2, Panizo A. 2, Herreros J. 3, Tamayo E. 1, Florez S. 1, Fulquet E. 1, Echevarria J. R. 1, Carrascal Y. 1, Fiz L. 1

1 Depart­ment of Car­diac Sur­gery, Uni­ver­si­ty Hos­pital,Val­la­dolid, ­Spain
2 Depart­ment of ­Pathology, Uni­ver­si­ty of ­Navarra, Pam­plona, ­Spain
3 Depart­ment of Car­di­o­vas­cular Sur­gery, Uni­ver­si­ty of ­Navarra, Pam­plona, ­Spain


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Aim. Apop­tosis is a ­type of pro­grammed ­cell ­death ­whereby, immu­no­logic, ­genetic and bio­chem­ical mech­a­nisms are ­involved in its con­trol. On the ­other ­hand, ­graft cor­o­nary ­artery dis­ease is the ­most impor­tant restric­tive ­factor for the ­long-­term sur­vival of ­heart trans­plan­ta­tion. The pur­pose of ­this ­study is to ana­lyse ­both apop­totic ­cell ­lesions in trans­planted ­patients ­that ­present cor­o­nary ­artery dis­ease.
­Methods. ­From ­August 1984 ­until ­December 1996, 148 ­heart trans­plants ­were car­ried out in the ­Clínica Uni­ver­si­taria de ­Navarra. In 102 ­patients, ­annual cor­o­nary angio­graphy was per­formed, ­reaching a diag­nosis of cor­o­nary ­artery dis­ease in 30 ­patients. ­Study of apop­totic ­cell ­death was ­done in the ­tissue of endo­myo­car­dial biop­sies on all ­patients by ­means of the ­TUNEL tech­nique. Pro­ce­dures of immu­no­his­to­chem­istry ­with anti­bodies ­antic-myc, p53 and bcl-2 ­were car­ried out and ­results ­were com­pared ­with a con­trol ­group of 30 ­patients ­with homo­ge­neous char­ac­ter­is­tics.
­Results. All ­patients ­with cor­o­nary ­artery dis­ease ­showed apop­totic car­di­om­yo­cytes, 13 ­patients to a ­mild ­degree, 14 to a mod­erate ­degree and 3 to a ­severe ­degree, ­while in the con­trol ­group apop­tosis was ­found ­only to a ­mild ­degree in 8 ­patients, ­obtaining a ­very sig­nif­i­cant sta­tis­tical dif­fer­ence (p<0.0001). The expres­sion of ana­lysed oncop­ro­teins was ­null in the 2 ­groups.
Con­clu­sion. Myo­car­dial apop­tosis is a con­stant ­finding in trans­planted ­patients ­with cor­o­nary ­artery dis­ease. We ­have not ­seen any cor­re­la­tion ­between the apop­totic pro­cess and ­genetic mech­a­nisms.

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