Investigation of the Effects of Endothelial Protection Solution on Oxidative Stress in Saphenous Vein Endothelium in Diabetic Patients undergoing Coronary Bypass

Yıl 2022, Cilt: 5 Sayı: 2, 25 - 29, 31.08.2022

Erhan Hafız , Özgür Altınbaş

https://doi.org/10.33713/egetbd.1131910

Öz

Objective: Saphenous vein grafts used for bypasses of diabetic coronary artery patients are occluded earlier than the normal patient population. In this study, the effects of endothelial protection solution on the protection of saphenous vein grafts taken during the operation against oxidative damage in diabetic patients were investigated.

Materials & Methods: The remaining parts of the saphenous vein grafts removed during the operation of 50 diabetic patients who underwent coronary bypass operation in our hospital between 2021 and 2022 were divided into three pieces. Each piece was placed into a different solution as saline (group 1), heparinized autologous blood (group 2), and endothelial protection solution (group 3). They were kept in solutions for 4 hours and then cellular and DNA oxidative stress markers were investigated.

Results: There was no significant difference between the groups in terms of total antioxidant capacity (TAC) (p>0.05). Total oxidative status (TOS) levels in groups 1 and 2 without endothelial solution (1.57±0.46 vs. 1.55±0.19) were significantly higher than those in group 3 (1.31±0.11) (p<0.05). Moreover, the oxidative stress index (OSI) was significantly lower in group 3 (p<0.05). On the other hand, 8-hydroxy-2'-deoxyguanosine (8-OHdG) levels, which indicate nuclear oxidative stress, were also found to be low in group 3 (p<0.05).

Conclusion: Our results support that the use of endothelial solution on saphenous vein grafts used in diabetic patients prevents oxidative damage.

Anahtar Kelimeler

Diabetic coronary artery disease, saphenous graft, oxidative stress, endothelial protection solution

Destekleyen Kurum

None declared

Proje Numarası

yok

Teşekkür

-

Koroner Bypass Uygulanan Diyabetik Hastalarda Endotel Koruma Solüsyonunun Safen Ven Endotelinde Oksidatif Stres Üzerine Etkilerinin İncelenmesi

Öz

Amaç: Diyabetik koroner arter hastalarının baypaslarında kullanılan safen ven greftleri normal hasta popülasyonundan daha erken tıkanır. Bu çalışmada, diyabetik hastalarda operasyon sırasında alınan safen ven greftlerinin oksidatif hasara karşı korunmasında endotel koruma solüsyonunun etkileri araştırıldı.

Gereç ve Yöntem: Hastanemizde 2021-2022 yılları arasında koroner bypass ameliyatı olan 50 diyabet hastasının operasyonu sırasında alınan safen ven greftlerinin kalan kısımları üç parçaya bölündü. Her parça salin (grup 1), heparinize otolog kan (grup 2) ve endotel koruma solüsyonu (grup 3) olmak üzere farklı bir solüsyona yerleştirildi. Çözeltilerde 4 saat bekletildikten sonra hücresel ve DNA oksidatif stres belirteçleri araştırıldı.

Bulgular: Toplam antioksidan kapasite (TAC) açısından gruplar arasında anlamlı fark yoktu (p>0.05). Toplam oksidatif durum (TOS) seviyeleri, endotel solüsyonu olmayan grup 1 ve 2'de (1,57±0,46'ya karşı 1,55±0,19) grup 3'ten (1,31±0,11) anlamlı olarak yüksekti (p<0,05). Ayrıca oksidatif stres indeksi (OSI) grup 3'te anlamlı olarak daha düşüktü (p<0.05). Öte yandan nükleer oksidatif stresi gösteren 8-hidroksi-2'-deoksiguanozin (8-OHdG) düzeyleri de grup 3'te düşük bulundu (p<0.05).

Sonuç: Sonuçlarımız diyabetik hastalarda kullanılan safen ven greftlerinde endotel solüsyonu kullanımının oksidatif hasarı önlediğini desteklemektedir.

Anahtar Kelimeler

Diyabetik koroner arter hastalığı, safen greft, oksidatif stres, endotel koruma solüsyonu

Proje Numarası

yok

Kaynakça

• 1. Onat A, Can G, Hergenç G, Küçükdurmaz Z, Uğur M, Yüksel H. High absolute coronary disease risk among Turks: involvement of risk factors additional to conventional ones. Cardiology. 2010;115(4):297-306. doi: 10.1159/000312009.
• 2. Matsuzawa Y, Guddeti RR, Kwon TG, Lerman LO, Lerman A. Treating coronary disease and the impact of endothelial dysfunction. Prog Cardiovasc Dis. 2015;57(5):431-42. doi: 10.1016/j.pcad.2014.10.004.
• 3. Ayan M, Saurav A, Kabach A, Smer A, Salih M, Abuzaid A, et al. TCT-280 Impact of Diabetes Mellitus on Graft Patency following Coronary Artery Bypass Graft Surgery: a Propensity Score Analysis. J Am Coll Cardiol. 2015; 66 (15_Supplement): B110. doi: 10.1016/j.jacc.2015.08.294
• 4. Yilmaz MB, Guray U, Guray Y, Biyikoglu SF, Tandogan I, Sasmaz H, et al. Metabolic syndrome negatively impacts early patency of saphenous vein grafts. Coron Artery Dis. 2006;17(1):41-4. doi: 10.1097/00019501-200602000-00007.
• 5. Raza S, Blackstone EH, Houghtaling PL, Rajeswaran J, Riaz H, Bakaeen FG, et al. Influence of Diabetes on Long-Term Coronary Artery Bypass Graft Patency. J Am Coll Cardiol. 2017;70(5):515-524. doi: 10.1016/j.jacc.2017.05.061.
• 6. Sabik JF 3rd. Understanding saphenous vein graft patency. Circulation. 2011;124(3):273-5. doi: 10.1161/CIRCULATIONAHA.111.039842. PMID: 21768550.
• 7. Shah PJ, Gordon I, Fuller J, Seevanayagam S, Rosalion A, Tatoulis J, et al. Factors affecting saphenous vein graft patency: clinical and angiographic study in 1402 symptomatic patients operated on between 1977 and 1999. J Thorac Cardiovasc Surg. 2003;126(6):1972-7. doi: 10.1016/s0022-5223(03)01276-5.
• 8. Yavuz, C, Demirtas, S, Yazıcı, S, Çalışkan A, Güçlü O, Karahan O, et al. Dietary addition of caffeic acid phenethyl ester protects myocardial tissue against ethambutol induced oxidative stres. Nobel Med. 2013;9 (3):120–124.
• 9. Yavuz C, Demirtas S, Guclu O, Karahan O, Caliskan A, Yazici S, Mavitas B. Rosuvastatin may have neuroprotective effect on spinal cord ischemia reperfusion injury. CNS Neurol Disord Drug Targets. 2013;12(7):1011-6. doi: 10.2174/18715273113129990085.
• 10. Ravikumar P, Ye J, Zhang J, Pinch SN, Hu MC, Kuro-o M, et al. α-Klotho protects against oxidative damage in pulmonary epithelia. Am J Physiol Lung Cell Mol Physiol. 2014;307(7):L566-75. doi: 10.1152/ajplung.00306.2013.
• 11. Hadi HA, Suwaidi JA. Endothelial dysfunction in diabetes mellitus. Vasc Health Risk Manag. 2007;3(6):853-76.
• 12. Avogaro A, Albiero M, Menegazzo L, de Kreutzenberg S, Fadini GP. Endothelial dysfunction in diabetes: the role of reparatory mechanisms. Diabetes Care. 2011;34 Suppl 2(Suppl 2):S285-90. doi: 10.2337/dc11-s239.
• 13. Adams JA, Uryash A, Lopez JR, Sackner MA. The Endothelium as a Therapeutic Target in Diabetes: A Narrative Review and Perspective. Front Physiol. 2021;12:638491. doi: 10.3389/fphys.2021.638491.
• 14. Ak E, Ak K, Midi A, Kervancıoğlu-Demirci E, Arsan S, Çetinel Ş, Pişiriciler R. Histopathologic evaluation of saphenous vein grafts in patients with type II diabetes mellitus undergoing coronary artery bypass grafting. Cardiovasc Pathol. 2021;52:107328. doi: 10.1016/j.carpath.2021.107328.
• 15. Kurlansky P. Graft patency in diabetic patients and the discomfort of thought. J Thorac Cardiovasc Surg. 2018 Jun;155(6):2316-2321. doi: 10.1016/j.jtcvs.2017.12.158. Epub 2018 Mar 11. PMID: 29609889.
• 16. Tezcan O, Karahan O, Alan M, Ekinci C, Yavuz C, Demirtas S, et al. Hyperbaric Oxygen Preconditioning Provides Preliminary Protection Against Doxorubicin Cardiotoxicity. Acta Cardiol Sin. 2017;33(2):150-155. doi: 10.6515/acs20160404b.
• 17. Tota Ł, Matejko B, Morawska-Tota M, Pilch W, Mrozińska S, Pałka T, et al. Changes in Oxidative and Nitrosative Stress Indicators and Vascular Endothelial Growth Factor After Maximum-Intensity Exercise Assessing Aerobic Capacity in Males With Type 1 Diabetes Mellitus. Front Physiol. 2021;12:672403. doi: 10.3389/fphys.2021.672403.
• 18. Tekin I, Demir M, Özdem S. Effect of different storage solutions on oxidative stress in human saphenous vein grafts. J Cardiothorac Surg. 2022;17(1):7. doi: 10.1186/s13019-022-01752-7.
• 19. Gunes AE, Yılmaz O, Erbas C, Dagli SN, Celik H. High serum 8-hydroxy-2'-deoxyguanosine levels predict DNA damage and aging in professional divers. Rev Assoc Med Bras (1992). 2021;67(11):1701-1705. doi: 10.1590/1806-9282.20210748.
• 20. Shi GX, Liu CZ, Wang LP, Guan LP, Li SQ. Biomarkers of oxidative stress in vascular dementia patients. Can J Neurol Sci. 2012;39(1):65-8. doi: 10.1017/s0317167100012701.
• 21. Di Minno A, Turnu L, Porro B, Squellerio I, Cavalca V, Tremoli E, et al. 8-Hydroxy-2-Deoxyguanosine Levels and Cardiovascular Disease: A Systematic Review and Meta-Analysis of the Literature. Antioxid Redox Signal. 2016 Apr 1;24(10):548-55. doi: 10.1089/ars.2015.6508. PMID: 26650622; PMCID: PMC4827317.
• 22. Kroese LJ, Scheffer PG. 8-hydroxy-2'-deoxyguanosine and cardiovascular disease: a systematic review. Curr Atheroscler Rep. 2014;16(11):452. doi: 10.1007/s11883-014-0452-y.