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International Angiology 2001 June;20(2):152-63

Copyright © 2002 EDIZIONI MINERVA MEDICA

lingua: Inglese

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


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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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