Unraveling the Distinctive Molecular Mechanisms of ITA, RA, and RGA for Enhanced Outcomes in Coronary Artery Bypass Grafting


Coronary Artery Bypass Grafting (CABG), a surgical intervention, enhances blood flow to the heart tissue, effectively addressing myocardial ischemia caused by coronary artery disease. In CABG, a healthy blood vessel is sourced from the patient and connected to the diseased Artery, bypassing the obstructed coronary artery region.

The primary sources for healthy blood vessels in CABG are internal thoracic artery (ITA), radial artery (RA), and right gastroepiploic artery (RGA). Among these, ITA exhibits the best long-term results, while RA and RGA are susceptible to intimal hyperplasia, atherosclerosis, and vasospasm.

Researchers from the Institute of Genetics and Developmental Biology (IGDB) at the Chinese Academy of Sciences, in partnership with Fuwai Hospital of the Chinese Academy of Medical Sciences, led by Wang Xiujie and Song Jiangping respectively, employed single-cell RNA sequencing (scRNA-seq) to investigate the cell type composition and gene expression profiles of ITA, RA, and RGA.

The researchers identified differences in lipid particle uptake, hemodynamics, vasospasm, and fibrosis between these three types of donor arteries. Based on experimental validation in human cells and mice, the following optimized strategies for CABG were suggested:

1. Inhibition of macrophage migration inhibitory factor (MIF) could minimize intimal hyperplasia in RA.
2. Potassium channel openers could counteract calcium antagonist-unresponsive vasospasm in RGA.
3. Inhibition of CREB5 and GDF10 could decrease extracellular matrix deposition and fibrosis in RA and RGA.
4. PCSK9 inhibitors are recommended for lipid-lowering treatment in ITA.

This study aims to offer valuable insights for the development of clinical CABG surgical strategies and the selection of post-operative medications.

1.  Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it