Endothelial dysfunction early after heart transplantation : assessment with intravascular ultrasound and doppler

Allograft vasculopathy after heart transplantation is thought to represent a response to endothelial injury in the graft vessels. To assess endothelial function before the onset of anatomic disease, coronary vasomotor responses to adenosine, acetylcholine, and nitroglycerin were evaluated in transpl...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 1992-10, Vol.86 (4), p.1171-1174
Main Authors: MILLS, R. M, BILLETT, J. M, NICHOLS, W. W
Format: Article
Language:English
Subjects:
Acetylcholine - pharmacology
Adenosine - pharmacology
Biological and medical sciences
Coronary Vessels - drug effects
Endothelium, Vascular - diagnostic imaging
Endothelium, Vascular - drug effects
Endothelium, Vascular - physiopathology
Heart Transplantation
Humans
Medical sciences
Nitroglycerin - pharmacology
Postoperative Period
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the heart
Ultrasonography - methods
Vasomotor System - drug effects
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Summary:Allograft vasculopathy after heart transplantation is thought to represent a response to endothelial injury in the graft vessels. To assess endothelial function before the onset of anatomic disease, coronary vasomotor responses to adenosine, acetylcholine, and nitroglycerin were evaluated in transplant recipients by intravascular ultrasound imaging and Doppler flow studies. Nine patients were studied 1 year after heart transplantation. Acetylcholine provoked significant vasoconstriction to 82% of maximal coronary diameter but was associated with an increase in mean coronary blood flow from 63.1 to 204 ml/min. Coronary blood flow increased fivefold in response to adenosine, a normal response. The vasomotor response to acetylcholine at 1 year after heart transplantation is consistent with endothelial dysfunction in the epicardial conduit vessels. Microvascular function as judged by coronary flow reserve appears to be normal.
ISSN:0009-7322
1524-4539
DOI:10.1161/01.CIR.86.4.1171