Intimal hyperplasia and coronary flow reserve after heart transplantation: association with big endothelin-1.
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.
Wexberg
Paul
P
Division of Cardiology, Department of Internal Medicine II, University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria. paul.wexberg@univie.ac.at
Pacher
Richard
R
Rödler
Suzanne
S
Kiss
Katharina
K
Beran
Gilbert
G
Grimm
Michael
M
Maurer
Gerald
G
Glogar
Dietmar
D
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
D015415:Biomarkers; D019332:Endothelin-1