Intimal hyperplasia and coronary flow reserve after heart transplantation: association with big endothelin-1

BACKGROUND: Endothelin, a peptide with strong vasoconstrictive and mitogenic properties, has been found to increase after cardiac transplantation. We therefore assessed the association between its precursor peptide, big endothelin-1, and intimal hyperplasia and coronary flow reserve after heart transplantation. METHODS: Thirty-five patients without hemodynamically significant coronary artery disease after heart transplantation were investigated: Average peak flow velocity in the left anterior descending artery (LAD) was assessed by intracoronary Doppler at baseline as well as after injection of adenosine; coronary flow reserve was calculated as a ratio of both and was corrected for patient age and baseline average peak flow velocity. Lumen, intima + media and total vessel area were measured by intracoronary ultrasound. The plasma concentration of big endothelin-1 in venous blood was determined by radioimmunoassay. RESULTS: Patients with elevated big endothelin-1 levels (>2 fmol/ml) tended to have a decreased corrected coronary flow reserve (2.60 +/- 0.9 vs 3.21 +/- 1.0, p = 0.078). They also had a significantly larger intima + media area (5.82 +/- 2.9 vs 2.37 +/- 2.9 mm(2), p = 0.004) and total vessel area (18.36 +/- 5.8 vs 12.81 +/- 4.8 mm(2), p = 0.012) than those with normal plasma concentrations. CONCLUSIONS: Our study suggests an association between elevated big endothelin-1 plasma levels and the development of intimal hyperplasia and reduction of coronary flow reserve after cardiac transplantation.     

Study of talc for pharmaceutical use. Trials of pharmacopoeias

A study has been carried out on the possible pharmaceutical use of spanish talcs following the normalized assays of the main european pharmacopoeia and other quantitative methods. Only the talc nr3, not processed, meets all the assays of pharmacopoeia. The samples 2 and 4 (crushed) exceed the highest tolerated content in chlorides. The talc 1 (also crushed) only meets the loss on drying. The measures of some of these assays by using quantitative methods lead to more correct results and even sometimes in opposition with those obtained by pharmacopoeia methods. The particle size estimated by shifting and sedimentation shows that the crushed talcs are silty, whereas the only talc not processed is sandy. Considering the medium sizes estimated by scanning microscopy, it can be said that the pulverization of the talcs 1, 2 and 4 is characteristic of a micronization.