title: Vascular resistance and endothelial function in cyclosporine-treated lung transplant recipients.
abstract: The majority of patients undergoing solid organ transplantation develop hypertension, to which vasoconstriction and impaired endothelial function have been suggested to contribute. We compared basal vascular resistance and nitric oxide-mediated endothelial-dependent and independent vasoreactivity between cyclosporine-treated lung transplant recipients and healthy subjects. Forearm blood flow was measured by venous occlusion plethysmography at rest and during acetylcholine, glyceryltrinitrate and N(G)-monomethyl-L-arginine acetate (L-NMMA) infusion in 11 lung transplant recipients 3-5 years after transplantation and in eight healthy subjects. Forearm vascular resistance (FVR) was calculated. Plasma levels of endothelin-1 (ET-1) and von Willebrand factor (vWf) were analysed. Basal vascular resistance was 40% lower in transplant recipients than in healthy subjects (P = 0.021). Endothelial-dependent and independent vasodilation did not differ. Plasma levels of ET-1 and vWf were higher in transplant recipients (P = 0.009 and P < 0.001 respectively). There was a significant correlation between ET-1 levels and FVR in healthy subjects (r = 0.83, P = 0.042), but not in transplant recipients (r = -0.14, P = 0.70). The findings oppose the theory of generalized vasoconstriction and impaired endothelial function in the pathogenesis of hypertension after transplantation. Increased plasma levels of ET-1 do not cause increased FVR in lung transplant recipients.
authors.affiliation: Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Martin
authors.initials: M
authors.lastname: Silverborn
authors.forename: Anneli
authors.initials: A
authors.lastname: Ambring
authors.forename: Folke
authors.initials: F
authors.lastname: Nilsson
authors.forename: Peter
authors.initials: P
authors.lastname: Friberg
authors.forename: Anders
authors.initials: A
authors.lastname: Jeppsson
mesh_terms: D000328:Adult; D000941:Antigens / Q000032:analysis; D001794:Blood Pressure; D016572:Cyclosporine / Q000627:therapeutic use*; D042783:Endothelial Cells / Q000502:physiology*; D019332:Endothelin-1 / Q000097:blood; D005260:Female; D006339:Heart Rate; D006801:Humans; D016040:Lung Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000502:physiology; D019001:Nitric Oxide Synthase / Q000037:antagonists & inhibitors; D014655:Vascular Resistance; D014841:von Willebrand Factor / Q000276:immunology
chemical_list: D000941:Antigens; D019332:Endothelin-1; C029417:Von Willebrand antigen; D014841:von Willebrand Factor; D009569:Nitric Oxide; D016572:Cyclosporine; D019001:Nitric Oxide Synthase