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Vascular endothelial growth factor in children with congenital heart disease
Yoshio Ootaki1, Masahiro Yamaguchi, Naoki Yoshimura
1Department of Cardiothoracic Surgery, Kobe Children's Hospital, Kobe, Hyogo, Japan. y.ootaki@nifty.ne.jp
Insights
Children with cyanotic heart disease show higher vascular endothelial growth factor (VEGF) levels. Elevated VEGF was particularly noted in those with single ventricle and asplenia syndrome, but did not correlate with abnormal vessel development.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Vascular Biology
Background:
- Cyanotic congenital heart disease (CCHD) is linked to abnormal vessel development, causing significant morbidity.
- These abnormalities include collateral arteries, venous collaterals, and pulmonary arteriovenous malformations.
- The underlying cause for these vascular anomalies in CCHD remains unidentified.
Purpose of the Study:
- To investigate if serum vascular endothelial growth factor (VEGF) levels are elevated in children with CCHD.
- To determine if elevated VEGF levels correlate with the presence of abnormal vessels in these patients.
Main Methods:
- Serum VEGF levels, oxygen saturation (SpO2), and blood cell counts (RBC) were measured preoperatively in children with CCHD (n=102) and acyanotic heart disease (n=61).
- Postoperative catheterization evaluated abnormal vessels in the CCHD group one month after surgery.
- Statistical analysis compared VEGF levels between groups and correlated them with SpO2, RBC, and vessel presence.
Main Results:
- VEGF levels were significantly higher in the CCHD group (355.0 pg/mL) compared to the acyanotic group (203.0 pg/mL; p < 0.001).
- Patients with single ventricle and asplenia syndrome within the CCHD group exhibited markedly elevated VEGF levels (711.9 pg/mL).
- No significant correlation was found between VEGF levels and SpO2, RBC, or the presence of abnormal vessels.
Conclusions:
- Children with CCHD demonstrate elevated systemic VEGF levels, with the highest levels observed in those with single ventricle and asplenia syndrome.
- The study found no significant association between VEGF levels and the development of abnormal vessels in children with CCHD.
Background:
Children with cyanotic congenital heart disease may experience the development of abnormal vessels that become a source of significant morbidity. Abnormal vessel proliferation in these children may take several forms, including systemic-to-pulmonary collateral arteries, systemic-to-pulmonary venous collaterals, systemic venous collateral channels after bidirectional cavopulmonary anastomosis, and pulmonary arteriovenous malformations. However, no entity responsible for these abnormalities has been identified yet. This study determined whether children with cyanotic congenital heart disease have elevated serum levels of vascular endothelial growth factor (VEGF) and whether elevated VEGF correlated with these abnormal vessels.
Methods:
Mean systemic room air oxygen saturation (SpO2), blood cell counts (RBC), and serum VEGF levels were measured preoperatively. Samples were obtained from 61 children with acyanotic heart disease (group N) and 102 children with cyanotic heart disease (group C) before cardiac surgery. Postoperative catheterization was performed 1-month after the operation to evaluate the abnormal vessels in group C.
Results:
The VEGF level was significantly elevated in group C (355.0 +/- 287.1 pg/mL) compared with group N (203.0 +/- 221.6 pg/mL; p < 0.001). VEGF levels in patients with a single ventricle associated with asplenia syndrome (n = 7) in group C were significantly elevated (711.9 +/- 443.5 pg/mL) compared with other patients. There was no significant correlation between VEGF level and SpO2 or RBC. Abnormal vessels were diagnosed in 19.6% (20/102) patients in group C. There was no difference in VEGF levels between the patients with abnormal vessels (336.8 +/- 182.5 pg/mL) and the patients without abnormal vessels (359.1 +/- 306.8 pg/mL).
Conclusions:
Children with cyanotic heart disease have elevated systemic levels of VEGF, especially in those patients with a single ventricle associated with asplenia syndrome. There was no significant relationship in VEGF levels between the patients with abnormal vessels and without these vessels.