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. 1997 Apr;77(4):353–356. doi: 10.1136/hrt.77.4.353

Vascular remodelling in intramyocardial resistance vessels in hypertensive human cardiac transplant recipients.

J T Jenkins 1, J J Boyle 1, I C McKay 1, D Richens 1, A R McPhaden 1, G B Lindop 1
PMCID: PMC484731  PMID: 9155616

Abstract

OBJECTIVE: Cardiac transplant recipients often develop hypertension as a side effect of immunosuppressive treatment. The aim of this study was to use the serial endomyocardial biopsies taken to monitor rejection to study the early and sequential arterial changes in human myocardial resistance arteries as hypertension develops. METHODS: At least 14 biopsies were studied from each of 23 patients, divided into a normotensive group (12 patients with a diastolic pressure never greater than 90 mm Hg) and a hypertensive group (11 patients with more than 10% of diastolic pressure measurements above 100 mm Hg). Morphometric analysis of between 30 and 50 arteries and arterioles in two widely separated histological levels from each biopsy was undertaken using an Optomax image analyser. RESULTS: There was a correlation between blood pressure, particularly diastolic pressure, and rate of medial thickening of intramyocardial coronary resistance arteries and arterioles (P = 0.0025). There was also a correlation between serum cyclosporin A concentrations and mean artery wall thickness (P = 0.003). CONCLUSIONS: Hypertension and cyclosporin A treatment are associated with significant wall thickening of intramyocardial resistance vessels in cardiac allograft recipients. These changes may be functionally and clinically important.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Auch-Schwelk W., Bossaller C., Götze S., Thelen J., Fleck E. Endothelial and vascular smooth muscle function after chronic treatment with cyclosporin A. J Cardiovasc Pharmacol. 1993 Mar;21(3):435–440. doi: 10.1097/00005344-199303000-00013. [DOI] [PubMed] [Google Scholar]
  2. Boyle J. J., Jenkins J., McKay I. C., McPhaden A. R., Lindop G. B. An assessment of the distortion of arteries due to sectioning in endomyocardial biopsies. J Pathol. 1997 Feb;181(2):243–246. doi: 10.1002/(SICI)1096-9896(199702)181:2<243::AID-PATH734>3.0.CO;2-A. [DOI] [PubMed] [Google Scholar]
  3. Gamble C. N. The pathogenesis of hyaline arteriolosclerosis. Am J Pathol. 1986 Mar;122(3):410–420. [PMC free article] [PubMed] [Google Scholar]
  4. Gibbons G. H., Dzau V. J. The emerging concept of vascular remodeling. N Engl J Med. 1994 May 19;330(20):1431–1438. doi: 10.1056/NEJM199405193302008. [DOI] [PubMed] [Google Scholar]
  5. Lever A. F. Slow pressor mechanisms in hypertension: a role for hypertrophy of resistance vessels? J Hypertens. 1986 Oct;4(5):515–524. doi: 10.1097/00004872-198610000-00001. [DOI] [PubMed] [Google Scholar]
  6. Locher R., Huss R., Vetter W. Potentiation of vascular smooth muscle cell activity by cyclosporin A. Eur J Clin Pharmacol. 1991;41(4):297–301. doi: 10.1007/BF00314955. [DOI] [PubMed] [Google Scholar]
  7. Marumo T., Nakaki T., Hishikawa K., Suzuki H., Kato R., Saruta T. Cyclosporin A inhibits nitric oxide synthase induction in vascular smooth muscle cells. Hypertension. 1995 Apr;25(4 Pt 2):764–768. doi: 10.1161/01.hyp.25.4.764. [DOI] [PubMed] [Google Scholar]
  8. Mulvany M. J. The development and regression of vascular hypertrophy. J Cardiovasc Pharmacol. 1992;19 (Suppl 2):S22–S27. doi: 10.1097/00005344-199219002-00006. [DOI] [PubMed] [Google Scholar]
  9. Paul L. C., Davidoff A., Benediktsson H. Cardiac allograft atherosclerosis in the rat. The effect of histocompatibility factors, cyclosporine, and an angiotensin-converting enzyme inhibitor. Transplantation. 1994 Jun 27;57(12):1767–1772. [PubMed] [Google Scholar]
  10. Potocnik S. J., Phillips P. A., Hardy K. J. Human resistance artery reactivity is altered by liver transplantation and treatment with cyclosporin A. Transplant Proc. 1992 Oct;24(5):2254–2255. [PubMed] [Google Scholar]
  11. Schwartzkopff B., Motz W., Frenzel H., Vogt M., Knauer S., Strauer B. E. Structural and functional alterations of the intramyocardial coronary arterioles in patients with arterial hypertension. Circulation. 1993 Sep;88(3):993–1003. doi: 10.1161/01.cir.88.3.993. [DOI] [PubMed] [Google Scholar]
  12. Schwartzkopff B., Motz W., Knauer S., Frenzel H., Strauer B. E. Morphometric investigation of intramyocardial arterioles in right septal endomyocardial biopsy of patients with arterial hypertension and left ventricular hypertrophy. J Cardiovasc Pharmacol. 1992;20 (Suppl 1):S12–S17. [PubMed] [Google Scholar]
  13. Short D. Morphology of the intestinal arterioles in chronic human hypertension. Br Heart J. 1966 Mar;28(2):184–192. doi: 10.1136/hrt.28.2.184. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Verbeke M., Van de Voorde J., de Ridder L., Lameire N. Functional analysis of vascular dysfunction in cyclosporin treated rats. Cardiovasc Res. 1994 Aug;28(8):1152–1156. doi: 10.1093/cvr/28.8.1152. [DOI] [PubMed] [Google Scholar]

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