Perek Bartłomiej, Kowalska Katarzyna, Kempisty Bartosz, Nawrocki Mariusz, Nowicki Michał, Puślecki Mateusz, Ostalska-Nowicka Danuta, Szarpak Łukasz, Ahmadi Navid, Malińska Agnieszka
Department of Cardiac Surgery and Transplantology, Chair of Cardio-Thoracic Surgery, Poznan University of Medical Sciences, Poznan, Poland.
Department of Histology and Embryology, Poznan University of Medical Sciences, Ul. Święcickiego6, 60-781 Poznań, Poland.
Cardiol J. 2020;27(6):817-824. doi: 10.5603/CJ.a2019.0087. Epub 2019 Sep 6.
Late failure of arterial aortocoronary conduits may result from abnormal activity of cells found in the vessel wall, including macrophages. The purpose of this study was to assess if there are any associations between the number of macrophages and overexpression of matrix metalloproteinases (MMPs) in the wall of arterial grafts, as well as their clinical significance.
This study involved 128 consecutive patients with a mean age of 64.9 ± 9.7 years who underwent elective surgery for coronary artery disease (CAD). The surplus segments of internal thoracic artery (ITA) and radial arteries (RA) were taken for immunohistochemical analysis of macrophage numbers and MMPs expression. The participants who reached the clinical primary end-point (cardiacrelated death, acute coronary syndrome or progression of CAD) had a follow-up angiography.
The mean numbers of macrophages were higher on RA (70 [24; 112]) than ITA cross-sections (44 [24; 59]; p < 0.001). Median expression of both MMP2 and MMP9 were stronger in the ITA than RA cross-sections (p < 0.001). A significant positive correlation of MMP2 expression and a number of macrophages infiltrating the tunica media of arterial segments were noted on both ITA and RA cross-sections. In addition, the arterial segments of the 6 patients who reached clinical end-point had higher numbers of macrophages and stronger MMP2 expression when compared to the rest of the participants.
Macrophage infiltration of arterial wall grafts prior to harvesting may be associated with higher risk of late occlusion and MMP2 might be facilitating this process.
主动脉冠状动脉血管移植后期失败可能是由于血管壁中发现的细胞（包括巨噬细胞）异常活动所致。本研究的目的是评估动脉移植物壁中巨噬细胞数量与基质金属蛋白酶（MMPs）过表达之间是否存在关联及其临床意义。
本研究纳入了128例连续的择期接受冠状动脉疾病（CAD）手术的患者，平均年龄为64.9±9.7岁。取胸廓内动脉（ITA）和桡动脉（RA）的多余节段进行巨噬细胞数量和MMPs表达的免疫组织化学分析。达到临床主要终点（心脏相关死亡、急性冠状动脉综合征或CAD进展）的参与者接受随访血管造影。
RA横截面上巨噬细胞的平均数量（70[24；112]）高于ITA横截面上的（44[24；59]；p<0.001）。ITA横截面上MMP2和MMP9的中位表达均强于RA横截面上的（p<0.001）。在ITA和RA横截面上均观察到MMP2表达与浸润动脉节段中膜的巨噬细胞数量呈显著正相关。此外，与其他参与者相比，达到临床终点的6例患者的动脉节段巨噬细胞数量更多，MMP2表达更强。
采集前动脉壁移植物的巨噬细胞浸润可能与后期闭塞的较高风险相关，且MMP2可能促进了这一过程。
