Coronary artery bypass graft (CABG) surgery is one of the most effective treatments for coronary artery disease. However, neointimal hyperplasia and ultimate luminal occlusion that is caused by vascular smooth muscle cell (VSMC) migration, proliferation and inflammatory response impede the long-term prognosis. The SOCS3 protein is involved in modulating various autoimmune and inflammatory diseases. However, the role of SOCS3 in vein graft disease is still unclear. We found that the mRNA and protein expression levels of IL-1β, IL-6, MCP-1, ICAM-1, TNF-α, STAT3, P-STAT3 and SOCS3 were significantly higher in the graft samples compared to normal veins. After transfecting the recombinant adenovirus carrying the rat SOCS3 gene into cultured rat VSMCs or grafting veins in rat, SOCS3 overexpression was found to significantly inhibit VSMC migration and proliferation in vitro and neointimal hyperplasia in vivo, respectively. Furthermore, SOCS3 overexpression inhibited VSMC migration and growth in vitro and alleviated VSMC inflammation in vitro by inhibiting STAT3 activation and phosphorylation. In conclusion, SOCS3 is a crucial physiological negative regulator for vein graft failure and provides a novel target for vein graft stenosis therapy after CABG.
Atrial fibrillation (AF) is the most common cardiac arrhythmia. AF is thought to be triggered by ectopic beats, originating primarily in the myocardial sleeves surrounding the pulmonary veins (PVs). The mechanisms underlying these cardiac arrhythmias remain unclear. To investigate this, frozen sections of heart and lung tissue from adult rats without arrhythmia were obtained in different planes, stained with Masson's trichrome, and immunolabeled for connexin 43 (Cx43), caveolin-3 (Cav3), hyperpolarization-activated cyclic nucleotide-gated channel 4 (HCN4), Nav1.5, Kir2.1, and the calcium handling proteins sarcoplasmic/endoplasmic reticulum calcium-ATPase 2a (SERCA2a) and ryanodine receptor 2 (RyR2). Transverse sections offered the best view of the majority of the PVs in the tissue samples. Cx43 was observed to be expressed throughout the atria, excluding the sinoatrial and atrioventricular nodes, and in the myocardial sleeves of the PVs. In contrast, HCN4 was only expressed in the sinoatrial and atrioventricular nodes. The immunodensity of Cav3, Nav1.5, Kir2.1, SERCA2a and RyR2 in the PVs imaged was similar to that in atria. The results suggest that in the absence of arrhythmia, the investigated molecular properties of the ion channels of rat PV cardiomyocytes resemble those of the working myocardium. This indicates that ectopic beats originating in the myocardial sleeves of the PVs occur only under pathological conditions.
Background: Prolonged mechanical ventilation (PMV) after cardiac surgery is associated with high morbidity and mortality. Patients following redo valve surgery possess many attributes that place them at risk for PMV, yet few studies particularly focused on them. The purpose of this study was to identify perioperative variables associated with PMV in redo valve surgery. Methods: A retrospective study, including 117 patients who underwent redo valve surgery from November 2017 to September 2021, was performed. The potential perioperative risk factors for PMV were collected. PMV was defined as the need for intubation and mechanical ventilation for >24 h, after completion of the operation. The clinical data were analyzed with univariate and multivariate analyses to identify risk factors for PMV following redo valve surgery. Results: The incidence of PMV was 38.5% (N = 45). Multiple logistic regression analysis showed perioperative risk factors for PMV included advanced age (age>57 years) [odds ratio (OR) 3.043, 95% confidence interval (CI) 1.172-7.905, P = 0.022], low weight (weight ≤58 kg) (OR 2.798, 95% CI: 1.088–7.199, P = 0.033), EuroSCORE II ≥6.8% (OR 3.467, 95% CI: 1.364–8.817, P = 0.009), and VIS at 12 hours post ICU admission (VIS12) >10 (OR 5.613, 95% CI: 2.211–14.249, P < 0.001). Conclusions: In adult patients undergoing redo valve surgery, advanced age, low weight, high EuroSCORE II and a high VIS at 12 hours post-ICU admission were associated with PMV. Hemodynamic status after operation were more important than preoperative and intraoperative variables in predicting PMV.
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