Urbanowicz Tomasz K, Gąsecka Aleksandra, Olasińska-Wiśniewska Anna, Michalak Michał, Rodzki Michał, Błażejowska Ewelina, Filipiak Krzysztof J, Kowalewski Mariusz, Tykarski Andrzej, Jemielity Marek
Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, Poznan, Poland.
1 Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
Postepy Kardiol Interwencyjnej. 2024 Dec;20(4):433-442. doi: 10.5114/aic.2024.145576. Epub 2024 Dec 2.
In multivessel coronary disease, interventional therapy is recommended to improve symptoms and survival. Inflammatory activation is postulated as one of the coronary atherosclerosis progression risk factors and prognostic indicators of surgical intervention. Counts of plasma extracellular vesicles (EVs) derived from erythrocytes, leukocytes, and platelets are elevated in patients with inflammatory diseases, including atherosclerosis-based cardiovascular diseases.
We aimed to estimate the association between blood flow measurements in coronary artery bypass grafts and EV plasma count changes in patients undergoing surgical coronary revascularization.
Forty-four consecutive patients who underwent surgical off-pump revascularization (33 males, 75%) in the median (Q1-Q3) age of 65 (58-69) were included. The blood flow in the implanted coronary artery bypass grafts was measured intraoperatively. EV counts were measured at baseline (hospital admission) and on the 1 and 3 postoperative days. The numbers of EVs from erythrocytes (CD235+), leukocytes (CD45+) and platelets (CD61+) were measured using flow cytometry with fluorescently labeled antibodies against specific antigens exposed on the EVs.
The numbers of leukocyte-derived EVs were lower in patients who received a LIMA-LAD graft ( = 0.020). The total EV plasma count changes were found significant for RIMA-LAD grafting ( = 0.028) and LIMA-LAD ( = 0.015) in arterial and arterio-venous grafting, respectively.
Surgical revascularizations affect EV plasma count, including significantly lower postoperative values of leukocyte-derived EVs related to left descending artery grafting.
在多支冠状动脉疾病中，推荐采用介入治疗以改善症状并提高生存率。炎症激活被认为是冠状动脉粥样硬化进展的危险因素之一，也是手术干预的预后指标。在包括动脉粥样硬化性心血管疾病在内的炎症性疾病患者中，源自红细胞、白细胞和血小板的血浆细胞外囊泡（EVs）计数会升高。
我们旨在评估冠状动脉搭桥术中血流测量与接受冠状动脉血运重建手术患者的EV血浆计数变化之间的关联。
纳入44例连续接受非体外循环血运重建手术的患者（33例男性，占75%），年龄中位数（四分位间距）为65岁（58 - 69岁）。术中测量植入的冠状动脉搭桥血管的血流。在基线（入院时）以及术后第1天和第3天测量EV计数。使用针对暴露于EVs上的特定抗原的荧光标记抗体，通过流式细胞术测量来自红细胞（CD235 +）、白细胞（CD45 +）和血小板（CD61 +）的EVs数量。
接受左内乳动脉 - 左前降支（LIMA - LAD）搭桥的患者白细胞衍生的EVs数量较低（P = 0.020）。在动脉搭桥和动静脉搭桥中，分别发现右内乳动脉 - 左前降支（RIMA - LAD）搭桥（P = 0.028）和LIMA - LAD搭桥（P = 0.015）后总EV血浆计数变化具有显著性。
手术血运重建会影响EV血浆计数，包括与左前降支搭桥相关的白细胞衍生的EVs术后值显著降低。
