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Circulation. 1997;95:1870-1876

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*Coronary Artery Bypass Surgery

(Circulation. 1997;95:1870-1876.)
© 1997 American Heart Association, Inc.


Articles

Different Effects of Thrombin Receptor Activation on Endothelium and Smooth Muscle Cells of Human Coronary Bypass Vessels

Implications for Venous Bypass Graft Failure

Presented in part at the 67th Annual Scientific Sessions of the American Heart Association, Dallas, Tex, November 14-17, 1994.

Zhihong Yang, MD; Frank Ruschitzka, MD; Ton J. Rabelink, MD; Georg Noll, MD; Friedgard Julmy; Hana Joch; Verena Gafner; Ivan Aleksic, MD; Ulrich Althaus, MD; Thomas F. Lüscher, MD

From the Departments of Cardiology, Cardiovascular Research (Z.Y., F.R., G.N., F.J., H.J., V.G., T.F.L.), and Cardiovascular and Thoracic Surgery (U.A.), University Hospital, Inselspital Bern, Switzerland; the Department of Nephrology and Hypertension (T.J.R.), University Hospital Utrecht, Netherlands; and the Department of Heart and Thoracic Surgery (I.A.), University Hospital, Göttingen, Germany.

Correspondence to Thomas F. Lüscher, MD, Professor of Medicine, Cardiology, Cardiovascular Research, University Hospital, Rämistrasse 100, CH-8091, Zürich, Switzerland.

Background Thrombin is implicated in coronary bypass graft disease; it cleaves its receptor's extracellular N-terminal domain and unmasks a new N-terminus as a tethered ligand. We studied the effects of thrombin receptor activation in human internal mammary artery (IMA) and saphenous vein (SV).

Methods and Results To study the effects of thrombin receptor activation on vasomotion, isolated blood vessels were suspended for isometric tension recording, and the effects on cell proliferation were studied in cultured smooth muscle cells (SMCs) of IMA and SV. Thrombin receptor expression in IMA and SV was analyzed by reverse transcription polymerase chain reaction and immunohistology. Receptor function was studied by analyzing the activation of mitogen-activated protein kinase (p42MAPK). In IMA thrombin evoked endothelium-dependent relaxations (65±5%) that were mimicked by thrombin receptor agonist peptide (TRAP) and reduced by the thrombin inhibitors recombinant (r-) hirudin and D-Phe-Pro-Arg-chloromethyl ketone (PPACK) (P<.05). In SV thrombin caused contractions (36±5% of 100 mmol/L KCl) that were inhibited by r-hirudin or PPACK (P<.05) but not mimicked by TRAP. In SMCs thrombin induced more pronounced [3H]thymidine incorporation (inhibited by r-hirudin or PPACK) in SV than IMA (P<.05), but activation of p42MAPK was similar in both vessels. TRAP induced weaker activation of p42MAPK than thrombin and did not stimulate [3H]thymidine incorporation in SMCs of SV or IMA. Immunohistology and RT-PCR demonstrated that the endothelium and SMCs of IMA and SV express thrombin receptor.

Conclusions Functional thrombin receptors are present on endothelium and SMCs of IMA and SV. Endothelial thrombin receptors mediate relaxation in IMA but not SV. Thrombin causes much more pronounced contraction and proliferation in SMCs of SV than IMA independent of tethered receptors, suggesting other thrombin receptors exist. These differences of thrombin receptor activation in IMA and SV may be important in the development of and therapy for graft disease.


Key Words: arteries • veins • receptors • grafting




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