title: Electron microscopic evaluation of internal thoracic artery endothelial morphology in diabetic coronary bypass patients.
abstract: BACKGROUND
  Diabetes is a well- identified major risk factor for cardiovascular diseases. This study was performed to evaluate the effect of diabetes and impact of glycemic control on internal thoracic artery (ITA) morphology by electron microscopy.
  
  
  METHODS
  Thirty patients scheduled for coronary artery bypass grafting were enrolled in this study. Samples of ITA were taken during the surgery for electron microscopic evaluation. Group I (n = 10) consisted of diabetics who have poor glycemic control (HbA1c > 7.5%), group II (n = 10) of well-regulated (HbA1c = 4.4% to 6.2%) diabetic patients, and group III (n = 10) of nondiabetic patients. Samples were prepared as ultrathin sections and an original semiquantitative method of scoring was applied to describe the morphologic changes of endothelium. Final scores were analyzed with analysis of variance and post hoc analysis.
  
  
  RESULTS
  In group I large vacuoles, swollen mitochondria were seen in endothelial cells and subendothelial edema was prominent. Endothelia (2.5 ± 1.2), arterial wall (2.0 ± 0.0), and endothelial mitochondria (2.9 ± 1.3) scores of group I were significantly higher than the other 2 groups (p < 0.001). The samples of group II and group III did not show significant differences with each other. The correlation between HbA1c values and total endothelial scores statistically significant (r = 0.912; p < 0.001).
  
  
  CONCLUSIONS
  There is a correlation between HbA1c values and morphologic changes of ITA graft. Uncontrolled diabetes is an important predictor of morphologic changes evidenced by the ultrastructural findings. These ultrastructural changes were not as prominent in the diabetes mellitus patients with well controlled metabolic statuses and patients without diabetes.
authors: Department of Cardiovascular Surgery, Bakirkoy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey. Electronic address: vedatbakuy@yahoo.com.
authors: Vedat
authors: V
authors: Bakuy
authors: Department of Cardiovascular Surgery, Bakirkoy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
authors: Orcun
authors: O
authors: Unal
authors: Department of Cardiovascular Surgery, Bakirkoy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
authors: Mete
authors: M
authors: Gursoy
authors: Department of Cardiovascular Surgery, Ataturk Training and Research Hospital, Ankara, Turkey.
authors: Aysegul
authors: A
authors: Kunt
authors: Department of Cardiovascular Surgery, 29 Mayis Hospital, Ankara, Turkey.
authors: Kanat
authors: K
authors: Ozisik
authors: Department of Anatomy, Faculty of Medicine, University of Hacettepe, Ankara, Turkey.
authors: Mustafa
authors: M
authors: Sargon
authors: Department of Cardiovascular Surgery, Ataturk Training and Research Hospital, Ankara, Turkey.
authors: Mustafa
authors: M
authors: Emir
authors: Department of Cardiovascular Surgery, Ataturk Training and Research Hospital, Ankara, Turkey.
authors: Erol
authors: E
authors: Sener
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D001026:Coronary Artery Bypass; D003920:Diabetes Mellitus / Q000097:blood / Q000473:pathology*; D004730:Endothelium, Vascular / Q000473:pathology* / Q000648:ultrastructure*; D005260:Female; D006801:Humans; D008297:Male; D008323:Mammary Arteries / Q000473:pathology* / Q000648:ultrastructure*; D008854:Microscopy, Electron; D008875:Middle Aged
chemical_list: D001786:Blood Glucose