Jt. Jenkins et al., VASCULAR REMODELING IN INTRAMYOCARDIAL RESISTANCE VESSELS IN HYPERTENSIVE HUMAN CARDIAC TRANSPLANT RECIPIENTS, HEART, 77(4), 1997, pp. 353-356
Objective-Cardiac transplant recipients often develop hypertension as
a side effect of immunosuppressive treatment. The aim of this study wa
s to use the serial endomyocardial biopsies taken to monitor rejection
to study the early and sequential arterial changes in human myocardia
l resistance arteries as hypertension develops. Methods-At least 14 bi
opsies were studied hem each of 23 patients, divided into a normotensi
ve group (12 patients with a diastolic pressure never greater than 90
mm Hg) and a hypertensive group (11 patients with more than 10% of dia
stolic pressure measurements above 100 mm Hg). Morphometric analysis o
f between 30 and 50 arteries and arterioles in two widely separated hi
stological levels from each biopsy was undertaken using an Optomax ima
ge analyser. Results-There was a correlation between blood pressure, p
articularly diastolic pressure, and rate of medial thickening of intra
myocardial coronary resistance arteries and arterioles (P = 0.0025). T
here was also a correlation between serum cyclosporin A concentrations
and mean artery wall thickness (P = 0.003). Conclusions-Hypertension
and cyclosporin A treatment are associated with significant wall thick
ening of intramyocardial resistance vessels in cardiac allograft recip
ients. These changes may be functionally and clinically important.