Abstract: Coronary artery bypass grafting (CABG) is one of the conventional treatments of coronary artery disease. Though the artery grafts have its own superiority, autologous great saphenous vein is still commonly used. Ten years after operation, half of the vein grafts will be occluded and half of the remainder will often undergo severe pathological conditions. The poor long term patency of vein grafts has become the bottleneck of the efficiency of CABG. The restenosis of vein grafts resulting from neointima and atherosclerosis has become an urgent problem waiting to be resolved. As the study on the molecular mechanism and pathophysiology of the vein grafts disease develops, many therapeutic schedules have been made, including drug therapy, external stent, expanding solution and gene therapy. By contrast, gene therapy has a broader prospect. This article will have a review on the prevention of restenosis of the vein grafts after CABG.
Abstract: Objective To evaluate if cardiac function and myocardial perfusion in acute ischemia myocardial transplanted by autologous bone mesenchymal stem cells (MSC) can be improved. Methods Sixteen New Zealand rabbits were studied.The left anterior descending coronary artery under the first diagonally branch was ligated to result in acute myocardial ischemia models,the sixteen models were divided into two groups with randomed number table. Control group(n=8): 0.6ml αminimum essential medium was injected into myocardium; transplanted group (n=8): 0.6ml medium of autologous MSC marked with 5-bromium,2-deoxy-uridine (BrdU) was injected into myocardium. Echocardiography were erformed to measure left ventricular ejection fraction(LVEF),as well as the displacement and strain of apex segment of left ventricle pre-ichemia,beforeand 4 weeks after treatment; the target myocardial tissues were harvested 4 weeks after treatment,double immunohistochemistry staining of anti-BrdU and anti-troponin T(TnT) were used to evaluate the survival and differentiation of implanted MSC; immunohistochemistry staining of anti-CD146 endothelium factor were used to evaluate the density of capillary vessels in treated myocardium. Results Double immunohistochemistry staining showed that positive cells were found in transplanted group and not found in control group. Anti-CD146 immunohistochemistry staining showed density of capillary vessels of transplanted group was significantly more than that of control group(Plt;0.05) ; LVEF,displacement and strain of cardiac apex of transplanted group improved significantly more than those of control group(Plt;0.05). Conclusion Transplanted to acute myocardium ischemia models of rabbits, MSC can differentiate into myocardium-like cells in myocardial microenvironment,and improve global and part cardiac systolic function and then improving perfusion of ischemia myocardium.