Impairment in forearm endothelium-dependent vasodilation after heart transplantation

Abstract

Background Endothelial dysfunction has been found in the peripheral circulation of patients with severe heart failure. However, whether the endothelial dysfunction improves after heart transplantation remains unknown. Our aim was to assess the forearm endothelium-dependent vasoreactivity one and six months after heart transplantation. Methods We studied 12 patients using high resolution brachial artery ultrasound to assess flow-mediated dilation induced by reactive hyperemia and nitroglycerin induced dilation (NTGdil). Results One month after heart transplantation, endothelium-dependent vasodilation was significantly impaired in 10 patients (83%), while it was preserved in the remaining two (17%) (0.4% ± 2.4% vs 9.9% ± 4.6%, respectively, P = .001). NTGdil was normal in both groups (12% ± 10% vs 23% ± 5%, respectively, P = NS). At six months, endothelial dysfunction was present in all patients including the two patients without endothelial dysfunction at the first study. Conclusions The present study demonstrates that peripheral endothelial dysfunction is present after heart transplantation despite the improvement in left ventricular function. More studies are needed to prove if endothelial dysfunction reversion may improve survival in heart transplantation.