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Lectin-like oxidized low density lipoprotein receptor-1 exhibits increased expression in the epicardial coronary arteries in patients with coronary artery disease. The intramyocardial paradox

Session Poster session 1

Speaker Andreas Synetos

Event : ESC Congress 2017

  • Topic : coronary artery disease, acute coronary syndromes, acute cardiac care
  • Sub-topic : Coronary Artery Disease (Chronic)
  • Session type : Poster Session

Authors : A Synetos (Athens,GR), S Spyropoulos (Athens,GR), M Gazouli (Athens,GR), K Toutouzas (Athens,GR), D Perrea (Athens,GR), D Tousoulis (Athens,GR), Y Chloroyiannis (Athens,GR)

A. Synetos1 , S. Spyropoulos2 , M. Gazouli2 , K. Toutouzas1 , D. Perrea2 , D. Tousoulis1 , Y. Chloroyiannis3 , 1University of Athens Medical School, 1st Department of Cardiology - Athens - Greece , 2Athens Medical School - Athens - Greece , 3Euroclinic of Athens - Athens - Greece ,

European Heart Journal ( 2017 ) 38 ( Supplement ), 182

Background: Intramyocardial paradox is defined as the difference in atherosclerosis between the intramyocardial and epicardial parts of the coronary arteries in patients with coronary artery disease. The lectin-like oxidized low density lipoprotein receptor-1 (LOX-1) expression has been implicated in the early steps of atherogenesis and may interfere with many factors to induce atherosclerosis.

Purpose: These evidences prompted us to investigate the role of LOX-1 as a part of an atherogenetic mechanism by measuring and comparing LOX-1 expression in human epicardial and intramyocardial coronary arteries.

Methods: An epicardial and an intramyocardial total artery wall specimen was obtained from 13 male patients, aged 61.9±10.3 years, that underwent coronary artery bypass graft surgery due to advanced three vessel coronary artery disease. All patients underwent total arterial myocardial revascularization using both pedicled mammary arteries and a radial artery, with a mean of 3.6 grafts per patient. A rhomboid shaped total wall ECA and ICA sample, with a long axis of 7–9mm and a short axis of ∼1mm, was obtained by dissection during grafting maneuvers of the vessels from each patient. Reverse transcription-polymerase chain reaction (PT-PCR) was used for LOX-1 mRNA. Total mRNA (1μg) was directly extracted from ECA and ICA samples by the acid guanidium-phenol-chloroform method using RNEasy kit (Qiagen, Germany) according to the manufacturer's protocol. The extracted total RNA was reverse-transcribed using OneStep RT-PCR kit (Qiagen Japan, Tokyo Japan). Reverse –transcribed material (1.5μL) was amplified with DNA polymerase (Invitrogen, California USA) using a primer pair specific to human LOX-1. Each LOX-1 mRNA was normalized with a band of the relative internal reference GAPDH mRNA. The relative intensities of bands of interest were analyzed using Gel Doc 2000 (Bio-Rad Labs, Hercules, CA) and expressed as ratio to the GAPDH mRNA band.

Results: The coronary artery bypass grafting was safe without complications for all patients. There was zero early mortality and all thirteen patients had an uneventful recovery with a mean of 6.2 days length of stay in the Hospital. A mean number of 3.6 arterial grafts were used in each patients in order to achieve total arterial revascularization. One-way Analysis Of Variance (ANOVA) showed that there was a statistically significant difference between mean LOX-1/GAPDH ratio of ECA samples and that of ICA samples (0.48±0.07 versus 0.35±0.03, p<0.001)

Conclusions: LOX-1 expression is higher in the ECAs compared to ICAs in patients with coronary artery disease. These findings may contribute to the explanation of the intramyocardial paradox

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