Remodeling of autologous saphenous vein grafts. The role of perivascular myofibroblasts

Circulation
Y ShiA Zalewski

Abstract

Aortocoronary saphenous vein grafts (SVGs) undergo structural changes that render them susceptible to atherosclerosis. Accordingly, the origin of neointimal hyperplasia-was examined in porcine arterialized SVGs to determine the mechanism of vein graft remodeling. At 2 to 4 days after surgery, the percentage of cells lacking differentiation markers characteristic for smooth muscle (SM) cells (ie, alpha-SM actin, desmin, and SM myosin) increased within the media of SVGs interposed in the carotid arteries (P < .001). At 7 to 14 days, these cells acquired a differentiated phenotype (ie, alpha-SM-actin positive/ variable desmin/SM-myosin negative) and accumulated in the neointima. At 3 months, the neointima was positive for alpha-SM actin but mostly negative for desmin, which contrasted with medial SMCs that were invariably positive for alpha-SM actin, desmin, and SM myosin. To determine the role of nonmuscle cells in the above process, perivascular wound fibroblasts were selectively labeled and found to translocate through the media of newly placed SVGs, contributing to neointimal formation. These migrating cells differentiated to myofibroblasts exhibiting sustained alpha-SM-actin expression. The intima of human SVGs, retrieved dur...Continue Reading

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