The addition of a weekly supervised exercise session to our current prehabilitation program did not further enhance postoperative walking capacity when compared to standard REHAB care. Sedentary patients, however, seemed more likely to benefit from PREHAB+. An association was found between energy spent in physical activity and 6MWD. This information is important to consider when designing cost-effective prehabilitation programs.
Abstract-The reactivity of the vascular wall to endothelin-1 (ET-1) is influenced by cholesterol, which is of possible importance for the progression of atherosclerosis. To elucidate signaling steps affected, the cholesterol acceptor methyl--cyclodextrin (mcd, 10 mmol/L) was used to manipulate membrane cholesterol and disrupt caveolae in intact rat arteries. In endothelium-denuded caudal artery, contractile responsiveness to 10 nmol/L ET-1 (mediated by the ET A receptor) was reduced by mcd and increased by cholesterol. Neither ligand binding nor colocalization of ET A and caveolin-1 was affected by mcd. Ca 2ϩ inflow via store-operated channels after depletion of intracellular Ca 2ϩ stores was reduced in mcd-treated caudal arteries, as shown by Mn 2ϩ quench rate and intracellular [Ca 2ϩ ] response. Expression of TRPC1, 3, and 6 was detected by reverse transcriptase-polymerase chain reaction, and colocalization of TRPC1 with caveolin-1 was reduced by mcd, as seen by immunofluorescence. Part of the contractile response to ET-1 was inhibited by Ni 2ϩ (0.5 mmol/L) and by a TRPC1 blocking antibody. In the basilar artery, exhibiting less store-operated channel activity than the caudal artery, ET-1-induced contractions were insensitive to the TRPC1 blocking antibody and to mcd. Increased store-operated channel activity in basilar arteries after organ culture correlated with increased sensitivity of ET-1 contraction to mcd. These results suggest that cholesterol influences vascular reactivity to ET-1 by affecting the caveolar localization of TRPC1. Key Words: arterial smooth muscle Ⅲ methyl--cyclodextrin Ⅲ caveolae Ⅲ endothelin Ⅲ store-operated Ca 2ϩ channels H ypercholesterolemia increases reactivity to endothelin-1 (ET-1) in experimental animals and humans. [1][2][3][4] This has been pointed out as one possible factor in the progression of atherosclerosis. [5][6][7] The mechanism of action has not been elucidated, although both endothelial dysfunction and altered smooth muscle reactivity have been proposed. 5 Lipoprotein particles may directly influence endothelial membrane-associated endothelial NO synthase activity by interfering with cholesterol-rich domains referred to as caveolae. 8 Although these effects modulate the endothelial influence on vascular tone, less is known regarding direct effects of cholesterol on vascular smooth muscle functions.Caveolae are 50-to 100-nm membrane invaginations that integrate many cellular receptor functions. 9 For instance, ET A receptors expressed in COS cells colocalize with the caveolae-associated protein caveolin. 10,11 The caveolar structure is disrupted after depletion of cholesterol with cyclodextrins, 12 and this correlates with a decreased contractility to ET-1, but not to depolarization or ␣ 1 -receptor stimulation, in endothelium-denuded rat caudal arteries. 13 Cholesterol might thus modulate the strength of caveolae-associated signaling, providing a basis for altered contractility in response to ET-1.Activation of the ET A receptor stimulates Ca 2ϩ inflow ov...
Occlusive vascular disease is a widespread abnormality leading to lethal or debilitating outcomes such as myocardial infarction and stroke. It is part of atherosclerosis and is evoked by clinical procedures including angioplasty and grafting of saphenous vein in bypass surgery. A causative factor is the switch in smooth muscle cells to an invasive and proliferative mode, leading to neointimal hyperplasia. Here we reveal the importance to this process of TRPC1, a homolog of Drosophila transient receptor potential. Using 2 different in vivo models of vascular injury in rodents we show hyperplasic smooth muscle cells have upregulated TRPC1 associated with enhanced calcium entry and cell cycle activity. Neointimal smooth muscle cells after balloon angioplasty of pig coronary artery also express TRPC1. Furthermore, human vein samples obtained during coronary artery bypass graft surgery commonly exhibit an intimal structure containing smooth muscle cells that expressed more TRPC1 than the medial layer cells. Veins were organ cultured to allow growth of neointimal smooth muscle cells over a 2-week period. To explore the functional relevance of TRPC1, we used a specific E3-targeted antibody to TRPC1 and chemical blocker 2-aminoethoxydiphenyl borate. Both agents significantly reduced neointimal growth in human vein, as well as calcium entry and proliferation of smooth muscle cells in culture. The data suggest upregulated TRPC1 is a general feature of smooth muscle cells in occlusive vascular disease and that TRPC1 inhibitors have potential as protective agents against human vascular failure.
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