Study of arterial and autonomic effects of cyclosporine in humans

Daniela Lucini, Richard V. Milani, Hector O. Ventura, Mandeep R. Mehra, Franz Messerli, Massimo Pagani

Research output: Contribution to journalArticlepeer-review

Abstract

Altered sympathetic activity and peripheral vascular function are suspected as a mechanism of the development of arterial hypertension in organ transplantation recipients treated with cyclosporine. We assessed whether cyclosporine might alter peripheral vascular properties or autonomic modulation of the sinus node and the vasculature during rest and standing. We examined 17 orthotopic heart transplantation recipients, 8 solid organ transplantation recipients, 17 patients with essential hypertension, and 42 normotensive control subjects. All except the normotensive control subjects were treated with a long-acting dihydropyridine calcium entry blocker; transplantation recipients also received cyclosporine-based immunosuppression. Radial artery compliance was reduced in patients with essential hypertension and in patients with heart and solid organ transplantation as compared with normotensive control subjects, with this reduction being more marked in heart transplantation recipients. At rest, R-R variance was lowest in heart transplantation recipients, denoting denervation. The spectral profile of both R-R and systolic blood pressure variability as well as the index of baroreflex gain was normal at rest in patients with solid organ transplantation. On standing, both transplantation groups demonstrated reduced responsiveness in markers of autonomic modulation. The decrease in arterial compliance in cyclosporine-induced hypertension seems to imply a degree of ventricular vascular uncoupling more apparent in heart transplantation recipients. These changes are associated with alterations in autonomic modulation that are evidenced by an orthostatic stimulus.

Original languageEnglish
Pages (from-to)1258-1263
Number of pages6
JournalHypertension
Volume35
Issue number6
Publication statusPublished - Jun 2000

Keywords

  • Arterial mechanics
  • Autonomic nervous system
  • Baroreflex
  • Compliance, arterial
  • Heart transplantation

ASJC Scopus subject areas

  • Internal Medicine

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