CARDIOVASCULAR ENGINEERING Journal for Extracorporeal Circulation, Assist Devices,Transplantation and Artificial Organs
	Volume 2, 1997, No 4

Impact of Transcardiac Cytokines, Nitric Oxide and Endothelin on Endothelium Dependent Coronary Flow Reserve After Heart Transplantation

S. M. Wildhirt, M. Weis, C. Schulze, N. Conrad, A. Kornberg, U. Wilbert-Lampen, G. Rieder, G. Enders, P. Ueberfuhr, H. Reichenspurner, W. von Scheidt, B. Reichart

Abstract:
Pro-inflammatory cytokines activate cardiac nitric oxide and endothelin production and may impair coronary flow reserve (CFR). We investigated these possible connections in 18 humans 1 month after cardiac transplantation. Patients were subjected to coronary angiography (evaluation of endothelium dependent CFR with acetylcholine) and endomyocardial biopsies (determination of myocardial gene expression of endothelin- and nitric oxide synthases isozymes). Coronary sinus and aortic blood samples were withdrawn for measurement of transcardiac production/release of cytokines (TNF-alpha, TNF-Rp1, TNF-Rp2, IL-6, sIL-2r), endothelin and nitrite. Five patients (29%) showed an impaired CFR, significant higher iNOS gene expression and transcardiac nitrite production. Plasma nitrite correlated with TNF-alpha levels in coronary sinus; patients with impaired CFR showed a higher transcardiac endothelin net extraction. These data suggest that activation of vasoactive and immunmodulatory mediators are associated with endothelial function and may be an early step in the development of transplant vasculopathy.

Keywords:
Cardiac transplantation, nitric oxide synthase isozymes, endothelin, coronary flow reserve, humans

Address for Correspondence:

Reference:
(CVE. 1997; 2 (4): 231-235)

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