Growth factor production by arterial and vein grafts: relevance to coronary artery bypass grafting
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Published on: September 10, 2018
A V Sterpetti1, A Cucina, B Randone
1Department of Surgery, University of Rome-La Sapienza, Italy.
Insights
Arterial grafts produce less platelet-derived growth factor (PDGF) and basic fibroblast growth factor (bFGF) than vein grafts. This lower production may explain why arterial grafts resist atherosclerosis and vein grafts develop myointimal hyperplasia.
Area of Science:
- Vascular biology
- Surgical research
- Biomedical engineering
Background:
- Saphenous vein grafts often fail late due to myointimal hyperplasia and atherosclerosis.
- Internal mammary artery grafts show resistance to atherosclerosis.
- Platelet-derived growth factor (PDGF) and basic fibroblast growth factor (bFGF) are implicated in hyperplasia and atherosclerosis.
Purpose of the Study:
- To compare the production of PDGF and bFGF in arterial versus vein grafts.
- To investigate the role of growth factors in graft failure mechanisms.
Main Methods:
- Interposition of arterial and vein grafts in Lewis rats.
- Organ culture of grafts in serum-free media.
- Measurement of PDGF and bFGF production and mitogenic activity.
Main Results:
- Arterial grafts produced significantly less PDGF and bFGF compared to vein grafts (p < 0.01).
- Vein grafts exhibited higher mitogenic activity in conditioned media (p < 0.001).
- Significant myointimal hyperplasia was observed in all vein grafts.
Conclusions:
- Lower PDGF and bFGF production by arterial grafts may contribute to their resistance to atherosclerosis.
- This finding helps explain the lower incidence of atherosclerotic changes in internal mammary artery bypass grafts.
Background:
Occlusion caused by myointimal hyperplasia, atherosclerosis, or both is the main reason for late failure of saphenous vein coronary artery bypass grafts. On the other hand, internal mammary artery grafts are usually spared from atherosclerosis. Evidence exists that platelet-derived growth factor (PDGF) and basic fibroblast growth factor (bFGF) are involved in the genesis of myointimal hyperplasia and atherosclerosis. The aim of this study was to assess the production of PDGF and bFGF by arterial and vein grafts.
Methods:
In 20 inbred Lewis rats alpha 1 cm long segment of arterial graft was interposed at the level of the abdominal aorta. In a control group of 20 Lewis rats alpha 1 cm long segment of vein graft was implanted at the level of the abdominal aorta. Animals were killed 4 weeks after operation, and the grafts were studied in serum-free organ culture to assess the production of PDGF and bFGF. RESULTS. Arterial grafts produced a smaller quantity of PDGF and bFGF than vein grafts (p < 0.01) Higher mitogenic activity was present in the conditioned media from vein grafts than in the conditioned media from arterial grafts (p < 0.001). A large amount of myointimal hyperplasia was present in all vein grafts.
Conclusions:
This phenomenon could explain the rarity of atherosclerotic changes in internal mammary coronary bypass grafts.
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