Transforming growth factor beta and myocardial dysfunction following heart transplantation

Abstract

Objective: We analyzed the role of transforming growth factor-beta (TGF-β), a fibrogenic cytokine, in the development of left ventricular diastolic dysfunction following heart transplantation. Methods: We studied 152 heart transplant recipients who had survived for at least 24 months. We compared histopathological findings (staining of endomyocardial biopsy specimens using Heamatoxlin Eosin and polyclonal antibodies), left ventricular function (Doppler echocardiography) and clinical course (NYHA status}. Patients are classified into group A (n=56 recipients) with immunohistochemical TGF-β staining score >7 and group B (n=96 recipients) with a staining score 50% stenosis) was 17 and 29% for recipients in group A compared to 4 and 6% for recipients in group B at 3 and 5 years follow-up, respectively (P=0.01 and P=0.005, respectively). Conclusions: TGF-β expression in cardiac allografts is associated with impaired graft function and limited survival. The pathogenesis of diastolic dysfunction may be an aberrant repair process following rejection due to increased TGF-β expression in transplant recipients.