POSSIBLE RELATIONSHIP BETWEEN HEAT-SHOCK-PROTEIN-70, CARDIAC HEMODYNAMICS, AND SURVIVAL IN THE EARLY PERIOD AFTER HEART-TRANSPLANTATION

Background Heat shock proteins (HSPs) are produced by cells in respons e to a wide variety of stresses. To determine a possible relationship between hemodynamic parameters and HSP 70 in the early postoperative p eriod after heart transplantation, we examined immunohistochemically t he inducible HSP 70 (anti-HSP 72) response in human heart biopsies, as well as the effect of myocardial rejection on HSP. Methods. A total o f 105 routinely processed endomyocardial biopsies from 15 consecutive patients who underwent heart transplantation were examined. Analysis o f hemodynamic and echocardiographic parameters were performed within 3 0 min and 12 hr after the biopsies. Results. Immunohistochemically det ected inducible HSP 70 was mainly located in the cytoplasm and nucleus /nucleolus of cardiomyocytes. Two specimens additionally showed HSP 70 -positive interstitial cells and smooth muscle cells of arteries, wher eas lymphocytes mere consistently negative, There was a significant re lation between the echocardiographically determined increased relaxati on time and positive HSP 70 staining (P<0.011). Patients with elevated right atrial pressure (P<0.098), as well as those with increased left ventricular end systolic diameter (P<0.06), showed a trend to higher HSP expression. Three patients who died of sepsis or multiorgan failur e showed significantly higher cytoplasmic HSP 70 expression compared w ith 12 patients with stable clinical course. In case of rejection, sig nificantly more patients showed no HSP expression, Conclusion. Althoug h only five patients showed organ rejection, our results suggest an in verse relationship between HSP expression and rejection with the possi bility of a role for HSP 70 as a graft marker to assess graft function .