Prominence of coronary arterial wall lipids in XXXX heart allografts. Implications for pathogenesis of @entity4065 .

@entity1 @entity8 @entity4065 @entity75 @entity229 @entity205 @entity165
Transplant @entity4065 is a major late complication in @entity1 heart allograft recipients and the pathogenesis of @entity4065 remains uncertain. The degree to which lipids and atheromata are involved in the @entity75 remains unsettled, and there is uncertainty regarding the significance of insudation or retention of lipids within the coronary artery walls of transplanted hearts. On current immunosuppressive regimens, most @entity1 experience an increased serum total @entity165 and low-density lipoprotein @entity165 after transplant. Elevation of these blood lipids has an undetermined relationship to @entity4065 . We carried out morphological, morphometric, immunohistochemical, ultrastructural, and biochemical studies of particular coronary artery segments from 23 unselected explant or autopsy allografts and donor age-matched native coronary controls. @entity1 died of cardiac and non-cardiac reasons over a period of 4 to 1610 days after transplant. Atheromata were frequent, and diffuse intra- and extra-cellular accumulation of lipids in both intimal and medial walls was documented by oil red O positivity, immunohistochemical staining (muscle-specific alpha-actin), transmission and scanning electron microscopy, and biochemical analysis. Mean total @entity165 , esterified @entity165 , free @entity165 , and phospholipid content (microgram/cm2 intimal surface area) and concentration (microgram/mg dry defatted weight) in arteriopathic coronaries were > 10-fold higher than in comparable native coronary segments. Extent of lipids in the arterial walls was highly correlated with digitized percent luminal narrowing, mean daily and cumulative @entity205 dose, and mean cumulative @entity229 dose. Our data suggests strongly that lipid accumulation is an important early and persistent phenomenon in the development of @entity8 .
