1
|
Choi Y, Jakob R, Ehret AE, von Bohemer L, Cesarovic N, Falk V, Emmert MY, Mazza E, Giampietro C. Stretch-induced damage in endothelial monolayers. BIOMATERIALS ADVANCES 2024; 163:213938. [PMID: 38959650 DOI: 10.1016/j.bioadv.2024.213938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 06/12/2024] [Accepted: 06/27/2024] [Indexed: 07/05/2024]
Abstract
Endothelial cells are constantly exposed to mechanical stimuli, of which mechanical stretch has shown various beneficial or deleterious effects depending on whether loads are within physiological or pathological levels, respectively. Vascular properties change with age, and on a cell-scale, senescence elicits changes in endothelial cell mechanical properties that together can impair its response to stretch. Here, high-rate uniaxial stretch experiments were performed to quantify and compare the stretch-induced damage of monolayers consisting of young, senescent, and aged endothelial populations. The aged and senescent phenotypes were more fragile to stretch-induced damage. Prominent damage was detected by immunofluorescence and scanning electron microscopy as intercellular and intracellular void formation. Damage increased proportionally to the applied level of deformation and, for the aged and senescent phenotype, induced significant detachment of cells at lower levels of stretch compared to the young counterpart. Based on the phenotypic difference in cell-substrate adhesion of senescent cells indicating more mature focal adhesions, a discrete network model of endothelial cells being stretched was developed. The model showed that the more affine deformation of senescent cells increased their intracellular energy, thus enhancing the tendency for cellular damage and impending detachment. Next to quantifying for the first-time critical levels of endothelial stretch, the present results indicate that young cells are more resilient to deformation and that the fragility of senescent cells may be associated with their stronger adhesion to the substrate.
Collapse
Affiliation(s)
- Young Choi
- ETH Zürich, Dep. of Mechanical and Process Engineering, Zürich, Switzerland
| | - Raphael Jakob
- ETH Zürich, Dep. of Mechanical and Process Engineering, Zürich, Switzerland
| | - Alexander E Ehret
- ETH Zürich, Dep. of Mechanical and Process Engineering, Zürich, Switzerland; Empa, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf, Switzerland
| | - Lisa von Bohemer
- University of Zurich, Institute of Regenerative Medicine, Schlieren, Switzerland
| | - Nikola Cesarovic
- ETH Zürich, Dep. of Health Sciences and Technology, Zürich, Switzerland; Deutsches Herzzentrum der Charité (DHZC), Department of Cardiothoracic and Vascular Surgery, Berlin, Germany; Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Volkmar Falk
- ETH Zürich, Dep. of Health Sciences and Technology, Zürich, Switzerland; Deutsches Herzzentrum der Charité (DHZC), Department of Cardiothoracic and Vascular Surgery, Berlin, Germany; Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Maximilian Y Emmert
- University of Zurich, Institute of Regenerative Medicine, Schlieren, Switzerland; Deutsches Herzzentrum der Charité (DHZC), Department of Cardiothoracic and Vascular Surgery, Berlin, Germany; Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Edoardo Mazza
- ETH Zürich, Dep. of Mechanical and Process Engineering, Zürich, Switzerland; Empa, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf, Switzerland.
| | - Costanza Giampietro
- ETH Zürich, Dep. of Mechanical and Process Engineering, Zürich, Switzerland; Empa, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf, Switzerland.
| |
Collapse
|
2
|
Grimsley EA, Torikashvili JV, Janjua HM, Read MD, Kothari AN, Verhagen NB, Pietrobon R, Kuo PC, Rogers MP. Nonelective coronary artery bypass graft outcomes are adversely impacted by Coronavirus disease 2019 infection, but not altered processes of care: A National COVID Cohort Collaborative and National Surgery Quality Improvement Program analysis. JTCVS OPEN 2023; 16:342-352. [PMID: 38204718 PMCID: PMC10775046 DOI: 10.1016/j.xjon.2023.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 08/15/2023] [Accepted: 09/18/2023] [Indexed: 01/12/2024]
Abstract
Objective The effects of Coronavirus disease 2019 (COVID-19) infection and altered processes of care on nonelective coronary artery bypass grafting (CABG) outcomes remain unknown. We hypothesized that patients with COVID-19 infection would have longer hospital lengths of stay and greater mortality compared with COVID-negative patients, but that these outcomes would not differ between COVID-negative and pre-COVID controls. Methods The National COVID Cohort Collaborative 2020-2022 was queried for adult patients undergoing CABG. Patients were divided into COVID-negative, COVID-active, and COVID-convalescent groups. Pre-COVID control patients were drawn from the National Surgical Quality Improvement Program database. Adjusted analysis of the 3 COVID groups was performed via generalized linear models. Results A total of 17,293 patients underwent nonelective CABG, including 16,252 COVID-negative, 127 COVID-active, 367 COVID-convalescent, and 2254 pre-COVID patients. Compared to pre-COVID patients, COVID-negative patients had no difference in mortality, whereas COVID-active patients experienced increased mortality. Mortality and pneumonia were higher in COVID-active patients compared to COVID-negative and COVID-convalescent patients. Adjusted analysis demonstrated that COVID-active patients had higher in-hospital mortality, 30- and 90-day mortality, and pneumonia compared to COVID-negative patients. COVID-convalescent patients had a shorter length of stay but a higher rate of renal impairment. Conclusions Traditional care processes were altered during the COVID-19 pandemic. Our data show that nonelective CABG in patients with active COVID-19 is associated with significantly increased rates of mortality and pneumonia. The equivalent mortality in COVID-negative and pre-COVID patients suggests that pandemic-associated changes in processes of care did not impact CABG outcomes. Additional research into optimal timing of CABG after COVID infection is warranted.
Collapse
Affiliation(s)
- Emily A. Grimsley
- Department of Surgery, University of South Florida Morsani College of Medicine, Tampa, Fla
| | | | - Haroon M. Janjua
- Department of Surgery, University of South Florida Morsani College of Medicine, Tampa, Fla
| | - Meagan D. Read
- Department of Surgery, University of South Florida Morsani College of Medicine, Tampa, Fla
| | - Anai N. Kothari
- Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wis
| | - Nate B. Verhagen
- Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wis
| | - Ricardo Pietrobon
- Department of Surgery, University of South Florida Morsani College of Medicine, Tampa, Fla
- SporeData, Inc
| | - Paul C. Kuo
- Department of Surgery, University of South Florida Morsani College of Medicine, Tampa, Fla
| | - Michael P. Rogers
- Department of Surgery, University of South Florida Morsani College of Medicine, Tampa, Fla
| |
Collapse
|
3
|
Zhang RJZ, Yu XY, Wang J, Lv J, Yu MH, Wang L, Liu ZG. Comparison of in-hospital outcomes after coronary artery bypass graft surgery in elders and younger patients: a multicenter retrospective study. J Cardiothorac Surg 2023; 18:53. [PMID: 36726146 PMCID: PMC9893615 DOI: 10.1186/s13019-023-02163-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 01/24/2023] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES We aimed to identify in-hospital outcomes in young (≤ 65 years) and old (> 65 years) patients after coronary artery bypass grafting (CABG) by analyzing the effect of age on adverse events after on-pump or off-pump CABG. METHODS Patients older than 65 years were defined as older patients and others were defined as younger patients. The qualitative data were compared by chi-square or Fisher's exact tests. The quantitative data were compared by the two-sample independent t-test or Mann-Whitney U test. Multifactor binary logistic regression was used to control for confounders and to investigate the effect of age on dichotomous outcome variables such as death. RESULTS In the on-pump CABG population, the postoperative in-hospital mortality, the incidence of postoperative symptomatic cerebral infarction (POSCI) and postoperative atrial fibrillation (POAF) was higher in older patients than in younger patients (P value < 0.05), and age > 65 years was associated with postoperative in-hospital mortality (OR = 2.370, P value = 0.031), POSCI (OR = 5.033, P value = 0.013), and POAF (OR = 1.499, P value < 0.001). In the off-pump CABG population, the incidence of POAF was higher in older patients than in younger patients (P value < 0.05), and age > 65 years was associated with POAF (OR = 1.392, P value = 0.011). CONCLUSION In-hospital outcomes after CABG are strongly influenced by age. In on-pump CABG, the risk of postoperative death, POSCI, and POAF was higher in older patients, and in off-pump CABG, the risk of POAF was higher in older patients.
Collapse
Affiliation(s)
- Ren-Jian-Zhi Zhang
- grid.506261.60000 0001 0706 7839Department of Cardiovascular Surgery, TEDA International Cardiovascular Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 61, Third Avenue, TEDA, Tianjin, China
| | - Xin-Yi Yu
- grid.506261.60000 0001 0706 7839Department of Cardiovascular Surgery, TEDA International Cardiovascular Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 61, Third Avenue, TEDA, Tianjin, China
| | - Jing Wang
- grid.412633.10000 0004 1799 0733Department of Cardiovascular Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jian Lv
- Department of Cardiovascular Surgery, Nanyang Central Hospital, Nanyang, China
| | - Ming-Huan Yu
- grid.506261.60000 0001 0706 7839Department of Cardiovascular Surgery, TEDA International Cardiovascular Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 61, Third Avenue, TEDA, Tianjin, China
| | - Li Wang
- grid.412633.10000 0004 1799 0733Department of Cardiovascular Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhi-Gang Liu
- grid.506261.60000 0001 0706 7839Department of Cardiovascular Surgery, TEDA International Cardiovascular Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 61, Third Avenue, TEDA, Tianjin, China
| |
Collapse
|