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To examine whether cardiac transplantation would reverse morphologic and hemodynamic changes in peripheral circulation in idiopathic dilated cardiomyopathy, the structure of terminal arterioles and minimal vascular resistance were measured in skin at the dorsum of the foot in the same 14 patients before and 80 ± 21 (mean ± SD) days and 387 ± 46 days after transplantation. The results were compared with data from a group of 16 healthy subjects. Blood flow was measured by the local technetium-99m pertechnetate washout method in a vascular bed relaxed with histamine. Structural microangiopathy (enhanced thickening of the basement membranes) in the arterioles was disclosed in skin biopsies in 11 of 14 patients before transplant, but in none of the 16 control subjects (p < 0.002). These abnormalities were unchanged 80 days after cardiac transplantation. However, arteriolar wall thickening was significantly reduced over the 1-year period after transplantation (p < 0.05), but this was not complete. Transplantation also led to a significant delayed decrease in minimal vascular resistance: before transplantation, 10.1 ± 3.2 mm Hg · ml−1 · 100 g · min (mean ± SD); 80 days after transplantation, 9.3 ± 3.1 mm Hg · ml−1 · 100 g · min (p = NS), and 1 year after transplantation 7.6 ± 2.4 mm Hg · ml−1 100 g · min (p < 0.01). Minimal vascular resistance before and 80 days after transplantation was significantly increased compared with that in healthy control subjects (6.3 ± 1.7 mm Hg · ml−1 100 g · min [p < 0.0003 and p < 0.003, respectively]). However, 1 year after transplantation, minimal vascular resistance was reduced to comparable levels when compared with that in control subjects (p = NS). These results indicate that structural microangiopathy and minimal vascular resistance in skin are improved slowly and gradually within the first year after orthotopic cardiac transplantation in patients with idiopathic dilated cardiomyopathy, however, the remodeling of histopathology is not accompanied by complete normalization.

Some data have demonstrated a substantial subdermal accumulation of topically applied drugs in animals. The aim of this study was to evaluate a possible effect of epicutaneously applied clobetasol propionate on blood flow in human subcutaneous adipose tissue. Nine healthy subjects were studied. The 133Xenon wash-out method was used for the measurement of subcutaneous blood flow. Resting blood flow and the local blood flow regulatory mechanisms, autoregulation of blood flow and the veno-arteriolar reflex, were assessed prior to treatment and were measured following 24, 48 and 72 h of treatment. The results demonstrated no effect of clobetasol propionate on resting subcutaneous blood flow or the local regulatory mechanisms.