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特定的移植治疗溶液可增强血管内皮功能。

Specific Graft Treatment Solution Enhances Vascular Endothelial Function.

作者信息

Kiss Attila, Szabo Petra Lujza, Dostal Christopher, Arnold Zsuzsanna, Geisler Daniela, Crailsheim Ingo, Folkmann Sandra, Grabenwöger Martin, Podesser Bruno Karl, Winkler Bernhard

机构信息

Ludwig Boltzmann Institute for Cardiovascular Research at the Center for Biomedical Research, Medical University Vienna, 1090 Vienna, Austria.

Department of Cardio-Vascular Surgery Vienna Heart Center Clinic Floridsdorf and Karl Landsteiner Institute for Cardio-Vascular Research, 1210 Vienna, Austria.

出版信息

Rev Cardiovasc Med. 2022 Oct 28;23(11):368. doi: 10.31083/j.rcm2311368. eCollection 2022 Nov.

DOI:10.31083/j.rcm2311368
PMID:39076175
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11269054/
Abstract

BACKGROUND

Saline is still the most widely used storage and rinsing solution for vessel grafts during cardiac surgery despite knowing evidence of its negative influence on the human endothelial cell function. Aim of this study was to assess the effect of DuraGraft©, an intraoperative graft treatment solution, on human saphenous vein segments and further elaborate the vasoprotective effect on rat aortic segments in comparison to saline.

METHODS

Human Saphenous vein (HSV) graft segments from patients undergoing aortocoronary bypass surgery (n = 15), were randomized to DuraGraft© (n = 15) or saline (n = 15) solution before intraoperative storage. Each segment was divided into two subsegmental parts for evaluation. These segments as well as rat aortic segments stored in DuraGraft© underwent assessment of vascular function in a multichamber isometric myograph system in comparison to Krebs-Henseleit solution (KHS), a physiologic organ buffer solution.

RESULTS

Potassium-Chloride (KCL)-induced contraction depicted a tendency towards increase when treated with DuraGraft© compared to saline preservation of HSV segments (23.02 14.77 vs 14.44 9.13 mN, = 0.0571). Vein segments preserved with DuraGraft© showed a significant improvement of endothelium-dependent vasorelaxation in response to cumulative concentrations of bradykinin compared to saline treated segments ( 0.05). Rat aortic segments stored in saline showed significantly impaired vasoconstriction (3.59 4.20, 0.0001) and vasorelaxation when compared to KHS and DuraGraft© ( 0.0001).

CONCLUSIONS

DuraGraft© demonstrated a favorable effect on graft relaxation and contraction indicating preservation of vascular endothelial function.

CLINICAL TRIAL REGISTRATION NUMBER

NCT04614077.

摘要

背景

尽管有证据表明生理盐水对人体内皮细胞功能有负面影响，但它仍是心脏手术中血管移植物最广泛使用的储存和冲洗溶液。本研究的目的是评估术中移植物治疗溶液DuraGraft©对人隐静脉段的影响，并与生理盐水相比，进一步阐述其对大鼠主动脉段的血管保护作用。

方法

将接受主动脉冠状动脉搭桥手术的患者（n = 15）的人隐静脉（HSV）移植物段在术中储存前随机分为DuraGraft©组（n = 15）或生理盐水组（n = 15）。每个段被分成两个亚段部分进行评估。与生理器官缓冲溶液克雷布斯 - 亨泽莱特溶液（KHS）相比，这些段以及储存在DuraGraft©中的大鼠主动脉段在多腔等长肌动描记系统中进行血管功能评估。

结果

与生理盐水保存的HSV段相比，用DuraGraft©处理时，氯化钾（KCL）诱导的收缩有增加的趋势（23.02±14.77对14.44±9.13 mN，P = 0.0571）。与生理盐水处理的段相比，用DuraGraft©保存的静脉段对缓激肽累积浓度的反应显示内皮依赖性血管舒张有显著改善（P <0.05）。与KHS和DuraGraft©相比，储存在生理盐水中的大鼠主动脉段显示血管收缩（3.59±4.20，P <0.0001）和血管舒张明显受损（P <0.0001）。

结论

DuraGraft©对移植物舒张和收缩显示出有利影响，表明血管内皮功能得以保留。

临床试验注册号

NCT04614077。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49ad/11269054/e5414b1057d3/2153-8174-23-11-368-g4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49ad/11269054/e6d126ac647a/2153-8174-23-11-368-g1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49ad/11269054/e595671ca592/2153-8174-23-11-368-g2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49ad/11269054/d0b8f3adfb47/2153-8174-23-11-368-g3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49ad/11269054/e5414b1057d3/2153-8174-23-11-368-g4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49ad/11269054/e6d126ac647a/2153-8174-23-11-368-g1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49ad/11269054/e595671ca592/2153-8174-23-11-368-g2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49ad/11269054/d0b8f3adfb47/2153-8174-23-11-368-g3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49ad/11269054/e5414b1057d3/2153-8174-23-11-368-g4.jpg

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本文引用的文献

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Effect of different storage solutions on oxidative stress in human saphenous vein grafts.不同保存液对人隐静脉移植物氧化应激的影响。
J Cardiothorac Surg. 2022 Jan 16;17(1):7. doi: 10.1186/s13019-022-01752-7.
2
A Novel Endothelial Damage Inhibitor Reduces Oxidative Stress and Improves Cellular Integrity in Radial Artery Grafts for Coronary Artery Bypass.一种新型内皮损伤抑制剂可减轻氧化应激并改善冠状动脉搭桥术中桡动脉移植物的细胞完整性。
Front Cardiovasc Med. 2021 Oct 6;8:736503. doi: 10.3389/fcvm.2021.736503. eCollection 2021.
3
Graft Preservation Solution DuraGraft Alleviates Vascular Dysfunction Following In Vitro Ischemia/Reperfusion Injury in Rats.
移植保存液DuraGraft减轻大鼠体外缺血/再灌注损伤后的血管功能障碍。
Pharmaceuticals (Basel). 2021 Oct 9;14(10):1028. doi: 10.3390/ph14101028.
4
Remote Ischemic Perconditioning Ameliorates Myocardial Ischemia and Reperfusion-Induced Coronary Endothelial Dysfunction and Aortic Stiffness in Rats.远程缺血预处理可改善大鼠心肌缺血再灌注诱导的冠脉内皮功能障碍和主动脉僵硬度。
J Cardiovasc Pharmacol Ther. 2021 Nov;26(6):702-713. doi: 10.1177/10742484211031327. Epub 2021 Aug 3.
5
No-touch saphenous vein grafts in coronary artery surgery (SWEDEGRAFT): Rationale and design of a multicenter, prospective, registry-based randomized clinical trial.冠状动脉手术中的非接触式隐静脉移植物（SWEDEGRAFT）：一项多中心、前瞻性、基于注册的随机临床试验的原理和设计。
Am Heart J. 2020 Jun;224:17-24. doi: 10.1016/j.ahj.2020.03.009. Epub 2020 Mar 13.
6
Sequential multidetector computed tomography assessments after venous graft treatment solution in coronary artery bypass grafting.冠状动脉搭桥术中静脉移植物治疗方案后的序贯多排螺旋计算机断层扫描评估
J Thorac Cardiovasc Surg. 2021 Jan;161(1):96-106.e2. doi: 10.1016/j.jtcvs.2019.10.115. Epub 2019 Nov 9.
7
Intraoperative storage of saphenous vein grafts in coronary artery bypass grafting.冠状动脉旁路移植术中隐静脉移植物的术中储存。
Expert Rev Med Devices. 2019 Nov;16(11):989-997. doi: 10.1080/17434440.2019.1682996. Epub 2019 Oct 30.
8
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J Cardiothorac Surg. 2019 Oct 15;14(1):174. doi: 10.1186/s13019-019-1010-z.
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Nat Rev Cardiol. 2020 Mar;17(3):155-169. doi: 10.1038/s41569-019-0249-3. Epub 2019 Aug 27.
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