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Danvin A, Quillard T, Espitia O, Charrier C, Guyomarch B, Gouëffic Y, Maurel B. Impact of Femoral Ossification on Local and Systemic Cardiovascular Patients' Condition. Ann Vasc Surg 2019; 60:335-345. [PMID: 31200045 DOI: 10.1016/j.avsg.2019.03.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 02/22/2019] [Accepted: 03/01/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Vascular calcifications are associated with a high cardiovascular morbi-mortality in the coronary territory. In parallel, femoral arteries are more calcified and develop osteoid metaplasia (OM). This study was conducted to assess the predictive value of OM and local inflammation on the occurrence of mid- and long-term adverse cardiovascular events. METHOD Between 2008 and 2015, 86 atheromatous samples were harvested during femoral endarterectomy on 81 patients and processed for histomorphological analyses of calcifications and inflammation (monocytes and B cells). Histological findings were compared with the long-term follow-up of patients, including major adverse cardiac event (MACE), major adverse limb event (MALE), and mortality. Frequencies were presented as percentage, and continuous data, as mean and standard deviation. A P-value < 0.05 was considered statistically significant. RESULTS Median follow-up was 42.4 months (26.9-58.8). Twenty-eight percent of patients underwent a MACE; a MALE occurred in 18 (21%) limbs. Survival rate was 87.2% at 36 months. OM was found in 41 samples (51%), without any significant impact on the occurrence of MACE, MALE, or mortality. Preoperative white blood cell formulae revealed a higher rate of neutrophils associated with MACE (P = 0.04) and MALE (P = 0.0008), correlated with higher B cells counts in plaque samples. CONCLUSIONS OM is part of femoral calcifications in almost 50% of the cases but does not seem to be an independent predictive variable for MACE or MALE. However, a higher rate of B cell infiltration of the plaque and preoperative neutrophil blood count may be predictive of adverse events during follow-up.
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Affiliation(s)
- Aurore Danvin
- CHU Nantes, l'institut du thorax, service de chirurgie vasculaire, Nantes, France
| | - Thibaut Quillard
- Laboratoire de Physiopathologie de la Résorption Osseuse, Inserm UMR S 1238, Nantes, France
| | - Olivier Espitia
- Laboratoire de Physiopathologie de la Résorption Osseuse, Inserm UMR S 1238, Nantes, France; CHU Nantes, unité de médicine vasculaire, Nantes, France; Université de Nantes, Nantes, France
| | - Céline Charrier
- Laboratoire de Physiopathologie de la Résorption Osseuse, Inserm UMR S 1238, Nantes, France
| | - Béatrice Guyomarch
- CHU Nantes, institut du thorax, INSERM, CNRS, UNIV Nantes, Nantes, France
| | - Yann Gouëffic
- CHU Nantes, l'institut du thorax, service de chirurgie vasculaire, Nantes, France; Laboratoire de Physiopathologie de la Résorption Osseuse, Inserm UMR S 1238, Nantes, France; Université de Nantes, Nantes, France
| | - Blandine Maurel
- CHU Nantes, l'institut du thorax, service de chirurgie vasculaire, Nantes, France; Laboratoire de Physiopathologie de la Résorption Osseuse, Inserm UMR S 1238, Nantes, France.
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Espitia O, Chatelais M, Steenman M, Charrier C, Maurel B, Georges S, Houlgatte R, Verrecchia F, Ory B, Lamoureux F, Heymann D, Gouëffic Y, Quillard T. Implication of molecular vascular smooth muscle cell heterogeneity among arterial beds in arterial calcification. PLoS One 2018; 13:e0191976. [PMID: 29373585 PMCID: PMC5786328 DOI: 10.1371/journal.pone.0191976] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 01/15/2018] [Indexed: 11/29/2022] Open
Abstract
Vascular calcification is a strong and independent predictive factor for cardiovascular complications and mortality. Our previous work identified important discrepancies in plaque composition and calcification types between carotid and femoral arteries. The objective of this study is to further characterize and understand the heterogeneity in vascular calcification among vascular beds, and to identify molecular mechanisms underlying this process. We established ECLAGEN biocollection that encompasses human atherosclerotic lesions and healthy arteries from different locations (abdominal, thoracic aorta, carotid, femoral, and infrapopliteal arteries) for histological, cell isolation, and transcriptomic analysis. Our results show that lesion composition differs between these locations. Femoral arteries are the most calcified arteries overall. They develop denser calcifications (sheet-like, nodule), and are highly susceptible to osteoid metaplasia. These discrepancies may derive from intrinsic differences between SMCs originating from these locations, as microarray analysis showed specific transcriptomic profiles between primary SMCs isolated from each arterial bed. These molecular differences translated into functional disparities. SMC from femoral arteries showed the highest propensity to mineralize due to an increase in basal TGFβ signaling. Our results suggest that biological heterogeneity of resident vascular cells between arterial beds, reflected by our transcriptomic analysis, is critical in understanding plaque biology and calcification, and may have strong implications in vascular therapeutic approaches.
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Affiliation(s)
- Olivier Espitia
- INSERM, UMR 1238, Nantes, France; Université de Nantes, Nantes Atlantique Universités, Laboratoire « Sarcome osseux et remodelage des tissus osseux calcifiés », Faculté de Médecine, Nantes, France
- CHU Hôtel Dieu, Nantes, France
| | - Mathias Chatelais
- INSERM, UMR 1238, Nantes, France; Université de Nantes, Nantes Atlantique Universités, Laboratoire « Sarcome osseux et remodelage des tissus osseux calcifiés », Faculté de Médecine, Nantes, France
| | - Marja Steenman
- Institut du Thorax, Inserm UMR1087, Faculté de Médecine, Université de Nantes, Nantes Atlantique Universités, Nantes, France
| | - Céline Charrier
- INSERM, UMR 1238, Nantes, France; Université de Nantes, Nantes Atlantique Universités, Laboratoire « Sarcome osseux et remodelage des tissus osseux calcifiés », Faculté de Médecine, Nantes, France
| | - Blandine Maurel
- INSERM, UMR 1238, Nantes, France; Université de Nantes, Nantes Atlantique Universités, Laboratoire « Sarcome osseux et remodelage des tissus osseux calcifiés », Faculté de Médecine, Nantes, France
- CHU Hôtel Dieu, Nantes, France
| | - Steven Georges
- INSERM, UMR 1238, Nantes, France; Université de Nantes, Nantes Atlantique Universités, Laboratoire « Sarcome osseux et remodelage des tissus osseux calcifiés », Faculté de Médecine, Nantes, France
| | - Rémi Houlgatte
- Inserm U954, Faculty of Medicine, Nancy, France, DRCI, University Hospital of Nancy, Nancy, France
| | - Franck Verrecchia
- INSERM, UMR 1238, Nantes, France; Université de Nantes, Nantes Atlantique Universités, Laboratoire « Sarcome osseux et remodelage des tissus osseux calcifiés », Faculté de Médecine, Nantes, France
| | - Benjamin Ory
- INSERM, UMR 1238, Nantes, France; Université de Nantes, Nantes Atlantique Universités, Laboratoire « Sarcome osseux et remodelage des tissus osseux calcifiés », Faculté de Médecine, Nantes, France
| | - François Lamoureux
- INSERM, UMR 1238, Nantes, France; Université de Nantes, Nantes Atlantique Universités, Laboratoire « Sarcome osseux et remodelage des tissus osseux calcifiés », Faculté de Médecine, Nantes, France
| | - Dominique Heymann
- Institut de Cancérologie de l'Ouest, site René Gauducheau, Boulevard Professeur Jacques Monod, Saint-Herblain, France
- University of Sheffield, Department of Oncology and Metabolism, INSERM, European Associated Laboratory “Sarcoma Research Unit”, Medical School, Sheffield, United Kingdom
- University of Nantes, Faculty of Medicine, Nantes, France
| | - Yann Gouëffic
- INSERM, UMR 1238, Nantes, France; Université de Nantes, Nantes Atlantique Universités, Laboratoire « Sarcome osseux et remodelage des tissus osseux calcifiés », Faculté de Médecine, Nantes, France
- CHU Hôtel Dieu, Nantes, France
| | - Thibaut Quillard
- INSERM, UMR 1238, Nantes, France; Université de Nantes, Nantes Atlantique Universités, Laboratoire « Sarcome osseux et remodelage des tissus osseux calcifiés », Faculté de Médecine, Nantes, France
- CHU Hôtel Dieu, Nantes, France
- * E-mail:
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