Six-month cardiovascular changes in cyclosporine-treated recipients of corneal grafts: serial baroreflex responses.
Loss of autonomic cardiovascular homoeostasis is often suspected in hypertension that has developed after organ transplantation. We serially assessed autonomic cardiovascular control in eight patients in generally good condition who needed cyclosporine (CyA) treatment because of high risk of rejection in corneal transplantation. To this aim, we investigated the patients, before and while they were receiving CyA, for 1 week and at 1, 3 and 6 months. For each period, spontaneous baroreflex, blood pressure, heart rate and variability were assessed, as well as neuro-hormonal indicators, while the patients were in both supine and 60 degrees upright positions. After 1 week of treatment, patients showed increases in systolic, diastolic and pulse blood pressures (P<0.05) that were concomitant with a transient decrease in plasma noradrenaline (P<0.05), which, thereafter, resumed the range of baseline values for 6 months. After patients had received CyA treatment for 1 month, the total power of systolic blood pressure variability and its low-frequency component remained higher than before treatment (P<0.05). At 3 and 6 months, heart rate was decreased (P<0.001) when high-frequency power of RR variability and plasma atrial natriuretic peptide were increased (P<0.05). As plasma noradrenaline never exceeded the baseline range, the hypertensive effect of CyA was not likely to have resulted from sympathetic activation. Rather, the increase in systolic blood pressure variability, its low-frequency component and the pattern of pulse pressure changes, pointed to a direct vascular effect of CyA. The maintenance of a normal cardiac baroreflex function during 6 months of CyA treatment might be pivotal to the adaptive responses towards direct CyA effects.
Bouhaddi
Malika
M
Department of Physiology, Functional Investigations, Hôpital Minjoz, Besançon University Hospital, 25030, Besançon, France. malika.bouhaddi@ufc-chu.univ-fcomte.fr
Delbosc
Bernard
B
Fortrat
Jacques-Olivier
JO
Henriet
Marie-Thérèse
MT
Cappelle
Sylvie
S
Ducloux
Didier
D
Chalopin
Jean-Marc
JM
Regnard
Jacques
J
D000328:Adult; D000368:Aged; D017704:Baroreflex; D001794:Blood Pressure; D016039:Corneal Transplantation; D016572:Cyclosporine / Q000009:adverse effects*; D005260:Female; D006084:Graft Rejection / Q000188:drug therapy*; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000139:chemically induced* / Q000503:physiopathology; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood; D011183:Postoperative Complications / Q000139:chemically induced / Q000503:physiopathology; D013564:Sympathetic Nervous System / Q000503:physiopathology
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D009638:Norepinephrine