Six-month cardiovascular changes in cyclosporine-treated recipients of corneal grafts: serial baroreflex responses

Abstract

Loss of autonomic cardiovascular homoeostasis is often suspected in hypertension that has developed after organ transplantation. We serially assessed autonomic cardiovascular control in eight patients in generally good condition who needed cyclosporine (CyA) treatment because of high risk of rejection in corneal transplantation. To this aim, we investigated the patients, before and while they were receiving CyA, for 1 week and at 1, 3 and 6 months. For each period, spontaneous baroreflex, blood pressure, heart rate and variability were assessed, as well as neuro-hormonal indicators, while the patients were in both supine and 60 degrees upright positions. After 1 week of treatment, patients showed increases in systolic, diastolic and pulse blood pressures (P<0.05) that were concomitant with a transient decrease in plasma noradrenaline (P<0.05), which, thereafter, resumed the range of baseline values for 6 months. After patients had received CyA treatment for 1 month, the total power of systolic blood pressure variability and its low-frequency component remained higher than before treatment (P<0.05). At 3 and 6 months, heart rate was decreased (P<0.001) when high-frequency power of RR variability and plasma atrial natriuretic peptide were increased (P<0.05). As plasma noradrenaline never exceeded the baseline range, the hypertensive effect of CyA was not likely to have resulted from sympathetic activation. Rather, the increase in systolic blood pressure variability, its low-frequency component and the pattern of pulse pressure changes, pointed to a direct vascular effect of CyA. The maintenance of a normal cardiac baroreflex function during 6 months of CyA treatment might be pivotal to the adaptive responses towards direct CyA effects.

Hyperoxia-induced alterations in cardiovascular function and autonomic control during return to normoxic breathing

“…The Table 1 Blood pressure data Values are means § SD. There were two experimental sessions (MA medical air session, OX oxygen session) with a sequence of six measurements periods as follows: baseline (ambient air), gas exposure (medical air breathing or 100% oxygen breathing), and then 10, 30, 60 and 90 min after gas exposure (recovery, ambient air) computed slope of cardiac baroreXex, a sound indicator of parasympathetic tone (Bouhaddi et al 2004), was lowered. Further, a cardiopulmonary baroreXex loading was also unlikely since the decrease in plasma Nt-proANP reXected a lowered cardiac Wlling.…”

Cardiovascular Autonomic Control During Short-Term Thermoneutral and Cool Head-Out Immersion

“…In each subject, plasma concentrations of noradrenaline, adrenaline, and dopamine were determined as described in a previous study ( 6 ). Radioimmunological methods were used for measurements of arginine vasopressin (Nichols Institute Diagnostics, San Clemente , CA) and atrial natriuretic perptide (ANP) (RPA512, Amersham Pharmacia Biotech, Buckinghamshire, UK ).…”

“…To study heart rate variability (HRV), blood pressure variability (BPV), and the sensitivity of the spontaneous barorefl ex, the duration of R-R intervals and beat-by-beat BP were recorded and analyzed according to the procedures described in a previous study ( 6 ). R-R interval was obtained continuously from a standard ECG.…”

Effect of preventive and regressive isosorbide 5-mononitrate treatment on catecholamine levels in plasma, platelets, adrenals, left ventricle and aorta in cyclosporin A-induced hypertensive rats

“…However, in human transplant recipients, the results were miscellaneous. While some studies have suggested an increased neural traffic related with CsA administration (Scherrer et al, 1990;Seals et al, 1993;Sander et al, 1996;Lucini et al, 2000;van de Borne et al, 2001), others have indicated normal or decreased sympathetic activity or no determinant influence for the CsA-hypertension (Floras et al, 1991;Elam et al, 1993;Kaye et al, 1993;Stein et al, 1995;Carvalho et al, 1999;Bouhaddi et al, 2004). The time elapsed after transplantation might possibly explain some of the discrepant results (van de Borne et al, 2001).…”