Functional effects of nitric oxide-releasing aspirin on vein conduits of diabetic patients undergoing CABG NO-aspirin and vein grafts in type-2 diabetes mellitus.
Articolo
Data di Pubblicazione:
2007
Abstract:
Background: Type 2 diabetes mellitus (DM) is known to negatively affect biological properties of venous vasculature, and, particularly, to
reduce endothelium-derived nitric oxide release. This condition might influence venous graft function following coronary artery bypass
surgery (CABG). The aim of this study was to evaluate the functional effects of a NO-releasing aspirin (NORA) on vein grafts (VG) of
diabetics and control patients undergoing elective CABG.
Methods: In 40 consecutive ischemic heart disease patients, the effects of NORA were tested on segments of saphenous vein conduits
harvested during elective CABG. Twenty patients had type-2 DM (mean age 69±2), whereas 20 patients had no DM (NDM) and represented
the control group (mean age 67±4). Functional responses were tested by exposing VGs to NORA and to standard vasoactive agents in an
organ-bath preparation. Histological features of VGs were also assessed by light and electronic microscopy.
Results: Significant impairment of endothelial-dependent vasodilation (acetylcholine induced) was documented in VGs of DM subjects.
NORA induced a significant and comparable vascular relaxation in all venous segments of NDM and DM patients (56±12% of maximal
relaxation vs 61±11% in the control group, respectively). Histology showed variable extent of vascular layer and cellular abnormalities in
VGs of diabetics (intimal hyperplasia, calcific deposition, endothelial cell degeneration) likely responsible of the endothelial functional
impairment, whereas control group VG showed preserved structures.
Conclusions: This preliminary study confirms the impairment of endothelium-dependent vasodilative property of VGs in DM patients. It also
indicates that NORA effectively induces vasodilation of VGs which was effective also in DM patients thereby representing a promising
therapy for diabetics undergoing CABG with the use of VGs, although further studies are mandatory to conclusively assess the safety and
benefits of this pharmacological agent.
reduce endothelium-derived nitric oxide release. This condition might influence venous graft function following coronary artery bypass
surgery (CABG). The aim of this study was to evaluate the functional effects of a NO-releasing aspirin (NORA) on vein grafts (VG) of
diabetics and control patients undergoing elective CABG.
Methods: In 40 consecutive ischemic heart disease patients, the effects of NORA were tested on segments of saphenous vein conduits
harvested during elective CABG. Twenty patients had type-2 DM (mean age 69±2), whereas 20 patients had no DM (NDM) and represented
the control group (mean age 67±4). Functional responses were tested by exposing VGs to NORA and to standard vasoactive agents in an
organ-bath preparation. Histological features of VGs were also assessed by light and electronic microscopy.
Results: Significant impairment of endothelial-dependent vasodilation (acetylcholine induced) was documented in VGs of DM subjects.
NORA induced a significant and comparable vascular relaxation in all venous segments of NDM and DM patients (56±12% of maximal
relaxation vs 61±11% in the control group, respectively). Histology showed variable extent of vascular layer and cellular abnormalities in
VGs of diabetics (intimal hyperplasia, calcific deposition, endothelial cell degeneration) likely responsible of the endothelial functional
impairment, whereas control group VG showed preserved structures.
Conclusions: This preliminary study confirms the impairment of endothelium-dependent vasodilative property of VGs in DM patients. It also
indicates that NORA effectively induces vasodilation of VGs which was effective also in DM patients thereby representing a promising
therapy for diabetics undergoing CABG with the use of VGs, although further studies are mandatory to conclusively assess the safety and
benefits of this pharmacological agent.
Tipologia CRIS:
Articolo su Rivista
Elenco autori:
Lorusso, R.; DE CICCO, G.; Beghi, Cesare; Gherli, T.; Poli, E.; Corradi, D.; Maestri, R.; Bonadonna, S.; Mancini, T.; Giustina, A.
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