title: Intimal hyperplasia and coronary flow reserve after heart transplantation: association with big endothelin-1.
abstract: BACKGROUND
  Endothelin, a peptide with strong vasoconstrictive and mitogenic properties, has been found to increase after cardiac transplantation. We therefore assessed the association between its precursor peptide, big endothelin-1, and intimal hyperplasia and coronary flow reserve after heart transplantation.
  
  
  METHODS
  Thirty-five patients without hemodynamically significant coronary artery disease after heart transplantation were investigated: Average peak flow velocity in the left anterior descending artery (LAD) was assessed by intracoronary Doppler at baseline as well as after injection of adenosine; coronary flow reserve was calculated as a ratio of both and was corrected for patient age and baseline average peak flow velocity. Lumen, intima + media and total vessel area were measured by intracoronary ultrasound. The plasma concentration of big endothelin-1 in venous blood was determined by radioimmunoassay.
  
  
  RESULTS
  Patients with elevated big endothelin-1 levels (>2 fmol/ml) tended to have a decreased corrected coronary flow reserve (2.60 +/- 0.9 vs 3.21 +/- 1.0, p = 0.078). They also had a significantly larger intima + media area (5.82 +/- 2.9 vs 2.37 +/- 2.9 mm(2), p = 0.004) and total vessel area (18.36 +/- 5.8 vs 12.81 +/- 4.8 mm(2), p = 0.012) than those with normal plasma concentrations.
  
  
  CONCLUSIONS
  Our study suggests an association between elevated big endothelin-1 plasma levels and the development of intimal hyperplasia and reduction of coronary flow reserve after cardiac transplantation.
authors.affiliation: Division of Cardiology, Department of Internal Medicine II, University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria. paul.wexberg@univie.ac.at
authors.forename: Paul
authors.initials: P
authors.lastname: Wexberg
authors.forename: Richard
authors.initials: R
authors.lastname: Pacher
authors.forename: Suzanne
authors.initials: S
authors.lastname: Rödler
authors.forename: Katharina
authors.initials: K
authors.lastname: Kiss
authors.forename: Gilbert
authors.initials: G
authors.lastname: Beran
authors.forename: Michael
authors.initials: M
authors.lastname: Grimm
authors.forename: Gerald
authors.initials: G
authors.lastname: Maurer
authors.forename: Dietmar
authors.initials: D
authors.lastname: Glogar
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000502:physiology; D003327:Coronary Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D019332:Endothelin-1 / Q000032:analysis / Q000097:blood*; D005260:Female; D016027:Heart Transplantation / Q000009:adverse effects / Q000379:methods*; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D006965:Hyperplasia / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D011336:Probability; D011863:Radioimmunoassay; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology*; D018608:Ultrasonography, Doppler; D018084:Ultrasonography, Interventional
chemical_list: D015415:Biomarkers; D019332:Endothelin-1