title: Patterns of myocardial endothelin-1 expression and outcome after cardiac transplantation.
abstract: BACKGROUND
  Endothelin-1 (ET-1), a potent vasoconstrictor, is released in response to several inflammatory cytokines after heart transplantation. The present study correlated patterns of myocardial ET-1 expression in heart biopsies with acute rejection, post-transplantation ischemic injury, and subsequent development of coronary vasculopathy.
  
  
  RESULTS
  Patterns of myocardial ET-1 expression were evaluated in 47 heart transplant recipients at 3 months after transplant. Transplant vasculopathy was documented by coronary angiography at 2 years after transplant. Expression of ET-1 was tabulated for both blood vessels and the interstitium. Vascular ET-1 expression was positive in 7/17 (41%) of patients with greater than grade 2 (International Society Heart Lung Transplant) rejection compared with 3/30 (10%) of patients with grade 0 and grade 1A rejection (P=0.02). Compared with patients with negative interstitial ET-1 expression (n=22), patients with positive interstitial ET-1 expression (n=25) had higher incidence of post-transplantation ischemic injury (52% versus 9%, P=0.002), lower mean episodes of acute rejection (> or = grade 2) during the first 3 months of transplant (1.09+/-0.66 versus 1.86+/-1.6, P=0.048), and more common vasculopathy at 2 years (50% versus 15%, P=0.02), and they tended to have worse survival (83.2% versus 100%, P=0.058).
  
  
  CONCLUSIONS
  Vascular ET-1 expression is likely to be associated with acute rejection. Interstitial ET-1 expression, however, is more likely to be associated with post-transplantation ischemic injury and subsequent development of coronary vasculopathy.
authors.affiliation: University of L'Aquila, Department of Internal Medicine and Public Health, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Ferri
authors.forename: Giuliana
authors.initials: G
authors.lastname: Properzi
authors.forename: Gianluca
authors.initials: G
authors.lastname: Tomassoni
authors.forename: Anna
authors.initials: A
authors.lastname: Santucci
authors.forename: Giovambattista
authors.initials: G
authors.lastname: Desideri
authors.forename: Anna Elisa
authors.initials: AE
authors.lastname: Giuliani
authors.forename: Randall C
authors.initials: RC
authors.lastname: Starling
authors.forename: Norman B
authors.initials: NB
authors.lastname: Ratliff
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Cook
authors.forename: Patrick
authors.initials: P
authors.lastname: McCarthy
authors.forename: James B
authors.initials: JB
authors.lastname: Young
authors.forename: Mohamad H
authors.initials: MH
authors.lastname: Yamani
mesh_terms: D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000209:etiology / Q000378:metabolism; D003331:Coronary Vessels / Q000378:metabolism; D019332:Endothelin-1 / Q000378:metabolism*; D006084:Graft Rejection / Q000378:metabolism; D016027:Heart Transplantation / Q000009:adverse effects / Q000000981:diagnostic imaging / Q000401:mortality; D006801:Humans; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging / Q000209:etiology / Q000378:metabolism; D009206:Myocardium / Q000378:metabolism*; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D019332:Endothelin-1