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A Journal on Angiology

Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
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International Angiology 2001 June;20(2):152-63

language: English

Risk factors of atherosclerosis and saphenous vein endothelial function

Sessa C., Morasch M. D., Friedland M., Kline R. A.

From ­the Department of Vascular Surgery, Wayne State University, Detroit ­USA


Background. Impaired vas­o­mo­tor func­tion ­has ­been sug­gest­ed as play­ing a ­role in ­the pathoph­y­sio­lo­gy of ath­ero­scler­o­sis ­and it ­may ­also ­affect ­the ­late paten­cy of ­bypass ­grafts. We eval­u­at­ed, in ­vitro, ­the influ­ence of ­risk fac­tors of ath­ero­scler­o­sis on saph­e­nous ­vein endo­the­lial func­tion in ­patients ­with car­di­o­vas­cu­lar dis­eas­es.
Methods. Forty-­five saph­e­nous ­vein ­rings ­with ­intact (E+) ­and denud­ed endo­the­li­um (E-) ­were stud­ied. The fol­low­ing ­drugs ­were ­used: nor­epi­neph­rine (NE), ace­tyl­cho­line (Ach), his­ta­mine (H) ­and serot­o­nine (5-HT).
Result. Contraction to nor­epi­neph­rine (n=15) ­showed a max­i­mal ten­sion of 783±115% ­that ­was ­increased in dia­bet­ics, smok­ers, and ­patients ­with hyper­ten­sion. There ­was a ­wide ­range of ­response to ace­tyl­cho­line in ­rings ­with ­intact endo­the­li­um (n=25), (­mean relax­a­tion 16.4±1.7%, rang­ing ­from -22.2% to 45%) ­with relax­a­tion (26±1.1%) ­and con­trac­tion (-11±1.2%); relax­a­tion ­was ­reduced in ­patients ­with hyper­ten­sion ­and in dia­bet­ics (7.4±2.6% vs ­non dia­bet­ics 24.4±1.73%; p<0.01). Five of ­the 12 ­veins ­from dia­bet­ics exib­it­ed con­trac­tion (10±1.48%). Histamine (n=15) ­caused mod­er­ate relax­a­tion at ­low dos­es (25±2.46%) fol­lowed by con­trac­tion at high­er con­cen­tra­tions (184±5.7%). This ­was great­er in dia­bet­ics (193±6.8% vs ­non dia­bet­ics 157±5.3%; p=0.045) ­while in prep­ar­a­tions with­out endo­the­li­um (n=10) ­only relax­a­tion ­was ­obtained (45±2.89%). Contraction (242±7.4%) ­was ­observed in ­response to serot­o­nine (n=15) ­that ­was ­not affect­ed by endo­the­lial remov­al. In ­this ­study saph­e­nous ­vein: (1) exhib­it­ed a ­wide ­range of respons­es to ace­tyl­cho­line; (2) ­evoked ­marked con­trac­tion to nor­epi­neph­rine ­and serot­o­nine; (3) elic­it­ed con­trac­tion in ­response to his­ta­mine ­that ­was endo­the­li­um-depen­dent, sug­gest­ing ­the pro­duc­tion or ­the ­release of an endo­the­li­um-­derived-con­tract­ing-fac­tor (­EDCF).
Conclusions. Saphenous ­vein is ­able to ­secrete a con­tract­ing fac­tor in ­patients ­with ­risk fac­tors of ath­ero­scler­o­sis ­and ­above ­all dia­betes. The mech­a­nisms ­that reg­u­late ­the bal­ance ­between ­the relax­ing ­and con­tract­ing fac­tors ­and ­how ­the endo­the­lial ­cells ­become ­the ­source of ­the sub­stanc­es ­with vas­o­con­stric­tor activ­ity ­remain to be deter­mined.

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