Vascular remodelling in intramyocardial resistance vessels in hypertensive human cardiac transplant recipients.
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.
Jenkins
J T
JT
University of Glasgow Department of Pathology, Western Infirmary, United Kingdom.
Boyle
J J
JJ
McKay
I C
IC
Richens
D
D
McPhaden
A R
AR
Lindop
G B
GB
D001160:Arterioles / Q000187:drug effects / Q000473:pathology; D003331:Coronary Vessels / Q000187:drug effects / Q000473:pathology*; D016572:Cyclosporine / Q000097:blood / Q000627:therapeutic use; D006084:Graft Rejection / Q000473:pathology; D016027:Heart Transplantation / Q000473:pathology*; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000473:pathology*; D014655:Vascular Resistance / Q000187:drug effects
D016572:Cyclosporine