title: Veins are no arteries: even moderate arterial pressure induces significant adhesion molecule expression of vein grafts in an ex vivo circulation model.
abstract: OBJECTIVE
  Coronary artery bypass grafting (CABG) is a standard procedure for treatment of coronary heart disease. Eighty percent of all CABGs are performed with venous grafts which then get exposed to an arterial pressure after surgery. This widely used procedure, however, is complicated by the development of alterations in the vein graft wall, leading to a decreased patency rate and graft failure. This study enlightens the influence of an even moderate arterial pressure on the gene expression of adhesion molecules in venous grafts which play a decisive role for the early induction of atherogenesis.
  
  
  METHODS
  Segments of porcine vena jugularis and arteria carotis were mounted in a simulated bypass circuit and subjected to pulsatile flow. Vessel segments were examined for adhesion molecule expression with quantitative real-time - polymerase chain reaction (qRT-PCR) and adherence of leukocytes was observed by confocal laser scanning microscopy and scanning electron microscopy.
  
  
  RESULTS
  Veins grafts subjected to an even moderate arterial pressure showed a 14-fold increase of ICAM-1 expression already after 4 hours. An arterial pressure of around 100/80 mmHg was enough to stimulate the adhesion molecule expression Furthermore it led to a 9-fold increase of leukocyte adhesion to the venous endothelium, but, in contrast this was not the case in arteries.
  
  
  CONCLUSIONS
  This study showed, that already 100 mmHg upregulates the expression of several adhesion molecules in pig veins followed by increased adhesion of leukocytes. Therefore, our data demonstrate the advantage of arteries for CABG, and that new therapeutic strategies are urgently necessary to protect vein grafts either physically or pharmacologically if arteries are not available for CABG.
authors: Department of Congenital and Pediatric Cardiac Surgery, Children Hospital, Clinical Research Laboratory, University Hospital Tuebingen, Germany.
authors: A
authors: A
authors: Nolte
authors: S
authors: S
authors: Secker
authors: T
authors: T
authors: Walker
authors: T O
authors: TO
authors: Greiner
authors: B
authors: B
authors: Neumann
authors: P
authors: P
authors: Simon
authors: G
authors: G
authors: Ziemer
authors: H P
authors: HP
authors: Wendel
mesh_terms: D000818:Animals; D001794:Blood Pressure; D002339:Carotid Arteries / Q000276:immunology*; D002448:Cell Adhesion; D015815:Cell Adhesion Molecules / Q000235:genetics / Q000378:metabolism*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D019040:E-Selectin / Q000378:metabolism; D005260:Female; D005786:Gene Expression Regulation; D066298:In Vitro Techniques; D018799:Intercellular Adhesion Molecule-1 / Q000378:metabolism; D007601:Jugular Veins / Q000276:immunology* / Q000637:transplantation; D007962:Leukocytes / Q000276:immunology; D018613:Microscopy, Confocal; D008855:Microscopy, Electron, Scanning; D010477:Perfusion; D011673:Pulsatile Flow; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013552:Swine; D013997:Time Factors; D019010:Vascular Cell Adhesion Molecule-1 / Q000378:metabolism
chemical_list: D015815:Cell Adhesion Molecules; D019040:E-Selectin; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1