PMID- 12821163
OWN - NLM
STAT- MEDLINE
DCOM- 20031223
LR  - 20191210
IS  - 1053-2498 (Print)
IS  - 1053-2498 (Linking)
VI  - 22
IP  - 6
DP  - 2003 Jun
TI  - Transforming growth factor beta and diastolic left ventricular dysfunction after 
      heart transplantation: echocardiographic and histologic evidence.
PG  - 663-73
AB  - BACKGROUND: The mechanism for chronic left ventricular diastolic dysfunction in 
      the non-rejecting cardiac allograft has not been fully studied. OBJECTIVES: The 
      purposes of this study were to analyze the significance and frequency of left 
      ventricular diastolic dysfunction after heart transplantation and to examine the 
      involvement of fibrotic cytokines (transforming growth factor beta [TGF-beta]) in 
      development of clinical and echocardiographic changes in cardiac allograft 
      recipients. METHODS: We studied 152 heart transplant recipients who had survived 
      for at least 24 months. We compared histopathologic findings (staining of 
      endomyocardial biopsy specimens using hematoxylin and eosin, and polyclonal 
      antibodies expressed as TGF-beta score), left ventricular function (Doppler 
      echocardiography), and clinical course (New York Heart Association [NYHA] 
      status). We classified patients into Group 1 (n = 41 recipients) with a 
      restrictive filling pattern, mitral deceleration time (MDT) <140 milliseconds, 
      and Group 2 (n = 111 recipients), MDT >or=140 milliseconds. RESULTS: The MDT was 
      122 +/- 7 milliseconds in Group 1 compared with an MDT of 177 +/- 17 milliseconds 
      in Group 2 (p = 0.0003). Group 1 showed significant immunohistochemical staining 
      in endomyocardial biopsy specimens (a mean TGF-beta score of 9.1 +/- 1.2 for 
      Group 1 compared with a mean TGF-beta score of 3.6 +/- 0.8 for Group 2 p = 
      0.001). The TGF-beta expression correlated inversely with both MDT and isovolumic 
      relaxation time (r = -0.77, p = 0.0004, and r = -0.69, p = 0.004, respectively). 
      Mean NYHA status in Group 1 recipients was 2.2 +/- 1.1 compared with 1.37 +/- 0.6 
      for Group 2 (p = 0.006). CONCLUSIONS: Transforming growth factor beta expression 
      in cardiac allografts is associated with impaired left ventricular diastolic 
      function. The pathogenesis of diastolic dysfunction may be an aberrant repair 
      process after rejection-caused TGF-beta expression in the allograft.
FAU - Aziz, Tarek M
AU  - Aziz TM
AD  - Cardiothoracic Transplant Unit, Wythenshawe Hospital, Manchester, United Kingdom. 
      tarekaziz55@hotmail.com
FAU - Burgess, Malcolm I
AU  - Burgess MI
FAU - Haselton, Philip S
AU  - Haselton PS
FAU - Yonan, Nizar A
AU  - Yonan NA
FAU - Hutchinson, Ian V
AU  - Hutchinson IV
LA  - eng
PT  - Comparative Study
PT  - Evaluation Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Heart Lung Transplant
JT  - The Journal of heart and lung transplantation : the official publication of the 
      International Society for Heart Transplantation
JID - 9102703
RN  - 0 (Transforming Growth Factor beta)
SB  - IM
MH  - Adult
MH  - Biopsy
MH  - Blood Pressure/physiology
MH  - Diastole/physiology
MH  - Echocardiography, Doppler
MH  - Female
MH  - Follow-Up Studies
MH  - Graft Rejection/etiology/metabolism
MH  - Heart Transplantation/*adverse effects
MH  - Humans
MH  - Immunohistochemistry
MH  - Male
MH  - Middle Aged
MH  - Myocardium/metabolism/pathology
MH  - Prevalence
MH  - Statistics as Topic
MH  - Stroke Volume/physiology
MH  - Systole/physiology
MH  - Time
MH  - Time Factors
MH  - Transforming Growth Factor beta/*metabolism
MH  - Treatment Outcome
MH  - United Kingdom/epidemiology
MH  - Vascular Resistance/physiology
MH  - Ventricular Dysfunction, Left/*etiology/*metabolism
EDAT- 2003/06/25 05:00
MHDA- 2003/12/24 05:00
CRDT- 2003/06/25 05:00
PHST- 2003/06/25 05:00 [pubmed]
PHST- 2003/12/24 05:00 [medline]
PHST- 2003/06/25 05:00 [entrez]
AID - S1053249802006575 [pii]
AID - 10.1016/s1053-2498(02)00657-5 [doi]
PST - ppublish
SO  - J Heart Lung Transplant. 2003 Jun;22(6):663-73. doi: 
      10.1016/s1053-2498(02)00657-5.