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冠状动脉旁路移植术中隐静脉周围皮下脂肪和血管周围脂肪组织表型的比较。

Comparison of Phenotypes in Subcutaneous Fat and Perivascular Adipose Tissue Surrounding the Saphenous Vein in Coronary Artery Bypass Grafting.

机构信息

Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine.

Department of Cardiovascular Surgery, National Hospital Organization, Obihiro Hospital.

出版信息

Circ J. 2023 May 25;87(6):791-798. doi: 10.1253/circj.CJ-22-0740. Epub 2023 Feb 3.

Abstract

BACKGROUND

The saphenous vein (SV) is used as an essential conduit in coronary artery bypass grafting (CABG), but the long-term patency of SV grafts is a crucial issue. The use of the novel "no-touch" technique of harvesting the SV together with its surrounding tissue has been reported to result in good long-term graft patency of SV grafts. We recently showed that perivascular adipose tissue (PVAT) surrounding the SV (SV-PVAT) had lower levels of metaflammation and consecutive adipose tissue remodeling than did PVAT surrounding the coronary artery. However, the difference between SV-PVAT and subcutaneous adipose tissue (SCAT) remains unclear.

METHODS AND RESULTS

Fat pads were sampled from 55 patients (38 men, 17 women; mean [±SD] age 71±8 years) with coronary artery disease who underwent elective CABG. Adipocyte size was significantly larger in SV-PVAT than SCAT. The extent of fibrosis was smaller in SV-PVAT than SCAT. There were no significant differences between SCAT and SV-PVAT in macrophage infiltration area, quantified by antibodies for CD68, CD11c, and CD206, or in gene expression levels of metaflammation-related markers. Expression patterns of adipocyte developmental and pattern-forming genes differed between SCAT and SV-PVAT.

CONCLUSIONS

The properties of SV-PVAT are close to, but not the same as, those of SCAT, possibly resulting from inherent differences in adipocytes. SV-PVAT has healthy expansion with less fibrosis in fat than SCAT.

摘要

背景

大隐静脉(SV)是冠状动脉旁路移植术(CABG)中必不可少的血管,但 SV 移植物的长期通畅率是一个关键问题。报道称,采用新型的“无接触”SV 及其周围组织采集技术可使 SV 移植物获得良好的长期通畅率。我们最近发现,SV 周围的血管周围脂肪组织(SV-PVAT)比冠状动脉周围的 PVAT 具有更低水平的代谢炎症和随后的脂肪组织重塑。然而,SV-PVAT 与皮下脂肪组织(SCAT)之间的差异尚不清楚。

方法和结果

从 55 名因冠心病行择期 CABG 的患者(38 名男性,17 名女性;平均[±标准差]年龄 71±8 岁)中取样脂肪垫。SV-PVAT 中的脂肪细胞大小明显大于 SCAT。SV-PVAT 中的纤维化程度小于 SCAT。用 CD68、CD11c 和 CD206 抗体定量的巨噬细胞浸润面积以及代谢炎症相关标志物的基因表达水平在 SCAT 和 SV-PVAT 之间无显著差异。SCAT 和 SV-PVAT 之间脂肪细胞发育和形态形成基因的表达模式不同。

结论

SV-PVAT 的特性与 SCAT 相似,但不完全相同,可能是由于脂肪细胞的固有差异所致。SV-PVAT 具有健康的扩张性,脂肪中的纤维化程度低于 SCAT。

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