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2 . 2022

Age-dependent remodeling of the internal thoracic artery extracellular matrix in patients with a combination of two or more cardiovascular risk factors


Background. Age-induced changes in the blood vessels have significant impact on target organs. As both cell populations and the extracellular matrix of the vascular wall are involved in the blood vessel remodeling, understanding of the ultrastructural consequences of these interactions are crucial for the development of novel therapeutic and surgical approaches for correcting impaired blood supply.

Aim. To investigate the ultrastructural features of the internal thoracic artery (ITA) in patients with a combination of ≥2 cardiovascular risk factors.

Material and methods. We assessed ITA segments used as the conduits for the coronary artery bypass graft surgery (n=30). Samples were fixed in paraformaldehyde with the further post-fixation in osmium tetroxide. After uranyl acetate staining and dehydration in ascending ethanol series followed by incubation in acetone, the samples were embedded into epoxy resin. Then, samples were grinded, polished, and counterstained with lead citrate. The samples were visualised by means of backscattered scanning electron microscopy.

Results. We identified three typical variants of ITA structure: 1) smooth muscle cell (SMC) phenotype with regularly oriented SMC layers and abundant extracellular matrix; 2) a fibroblastic phenotype where fibroblasts and collagen fibers prevailed; 3) a mixed phenotype. One of the ITA samples contained signs of the infection.

Conclusion. Smooth muscle cell, fibroblastic and mixed ITA phenotypes represent different and interconnected stages of vascular remodeling associated with the intimal injury and disruption of the internal elastic lamina. Migration of leukocytes into the vascular wall provokes the transformation of its cellular composition.

Keywords:age-associated arterial remodelling; ultrastructure of the arterial wall; elastolysis; internal mammary artery; neointima

Funding. This study was supported by the Complex Program of Basic Research under the Siberian Branch of the Russian Academy of Sciences within the Basic Research Topic of Research Institute for Complex Issues of Cardiovascular Diseases  Nо. 0419-2021-001 “Novel anti-atherosclerotic therapies and machine learning solutions for automated diagnosis and prognostication of cardiovascular disease”. The study is financially supported by the Ministry of Science and Higher Education of the Russian Federation (National Project Science and Universities).
Conflict of interest. The authors declare no conflict of interest.
For citation: Mukhamadiyarov R.A., Frolov A.V., Kutikhin A.G. Age-dependent remodeling of the internal thoracic artery extracellular matrix in patients with a combination of two or more cardiovascular risk factors. Clinical and Experimental Surgery. Petrovsky Journal. 2022; 10 (2): 33–45. DOI:  (in Russian)


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Sergey L. Dzemeshkevich
MD, Professor (Moscow, Russia)
Medicine today

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