Cardiac transplantation and resistance artery myogenic tone

被引:10
作者
Moien-Afshari, F
Skarsgard, PL
McManus, BM
Laher, I [1 ]
机构
[1] Univ British Columbia, Fac Med, Dept Pharmacol & Therapeut, Vancouver, BC V6T 1Z3, Canada
[2] Univ British Columbia, Fac Med, Dept Surg, Div Cardiovasc & Thorac Surg, Vancouver, BC V6T 1Z3, Canada
[3] St Pauls Hosp, iCAPTURE Ctr, McDonald Res Labs, Dept Clin Pathol, Vancouver, BC V6Z 1Y6, Canada
关键词
myogenic tone; smooth muscle; nitric oxide; transplantation; edema;
D O I
10.1139/Y04-100
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Transplantation is an effective treatment for end-stage heart disease; however, most grafts eventually fail by progressive cardiac failure. Primarily, failure is ischemic due to the occlusive nature of transplant vascular disease (TVD). Early after transplantation and preceding TVD, alterations in coronary physiology such as reduced vascular myogenic tone occur. Resistance arteries possess an inherent ability to constrict in response to transmural pressure; this constrictive response (myogenic tone) is important in fluid homeostasis. Recent evidence suggests that a decline in myogenic tone leads to deficits in cardiac contractility. Factors that reduce myogenic tone in transplantation include constitutive nitric oxide synthase and inducible nitric oxide synthase catalyzed, NO-mediated vasodilation as well as deficits in arterial contractile function. Reduced myogenic tone in allograft resistance arteries increases coronary blood flow such that hydrostatic pressure surpasses oncotic pressure, causing cardiac interstitial edema. This generalized edema decreases ventricular compliance leading to heart failure during the course of acute immune rejection of the graft. Cyclosporine A treatment reduces immune mediated dysregulation of myogenic tone, resulting in reduced interstitial edema and improved cardiac function. In this review, we discuss aspects of TVD and myogenic tone signaling mechanisms and how aberrations in myogenic regulation of arterial tone contribute to functional changes observed in cardiac transplant.
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页码:840 / 848
页数:9
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