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Published on: March 10, 2020
Increased vascular endothelial growth factor in patients with cyanotic congenital heart diseases may not be
Kenji Suda1, Masahiko Matsumura, Setsuko Miyanish
1Department of Pediatrics, Tenri Hospital, Tenri City, Japan. kensuda@tenriyotozu-hp.or.jp
Insights
Serum vascular endothelial growth factor (VEGF) is elevated in patients with cyanotic congenital heart disease (C-CHD). Biventricular repair normalizes VEGF, but Fontan operations may not, especially in younger patients.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Vascular Biology
Background:
- Cyanotic congenital heart disease (C-CHD) is associated with complex physiological changes.
- Vascular endothelial growth factor (VEGF) plays a crucial role in angiogenesis and vascular permeability.
- Understanding VEGF levels in C-CHD is important for assessing disease severity and treatment outcomes.
Purpose of the Study:
- To investigate the serum concentration of vascular endothelial growth factor (VEGF) in patients with cyanotic congenital heart disease (C-CHD).
- To evaluate the correlation between serum VEGF levels, arterial oxygen saturation, and hemodynamic variables.
- To compare VEGF levels across different C-CHD patient groups and after surgical interventions.
Main Methods:
- Serum VEGF levels were measured in four groups: healthy controls, C-CHD patients, post-biventricular repair, and post-Fontan operation.
- Correlation analyses were performed between serum VEGF, arterial oxygen saturation, age, and hemodynamic parameters.
- Statistical comparisons of VEGF levels were conducted among the study groups.
Main Results:
- Serum VEGF showed a significant negative correlation with arterial oxygen saturation (r = -0.62, p < 0.0001).
- Patients with C-CHD and those who underwent Fontan operations had significantly higher serum VEGF levels compared to controls and post-biventricular repair patients.
- Serum VEGF correlated negatively with age and positively with systemic venous pressure in specific patient subgroups.
Conclusions:
- Elevated serum VEGF in C-CHD patients is directly related to the degree of cyanosis.
- Biventricular repair effectively normalizes both cyanosis and serum VEGF levels.
- Fontan-type operations may lead to persistent elevation of serum VEGF, potentially due to increased venous pressure and younger age.
Background:
To determine the change of serum concentration of vascular endothelial growth factor (VEGF) in patients with cyanotic congenital heart disease (C-CHD).
Methods:
Patients comprised four groups: group A, 19 patients without cyanosis; group B, 24 patients with C-CHD; group C, 17 patients who had C-CHD and underwent biventricular repair; and group D, 15 patients who had single ventricle and underwent a Fontan type operation. Blood samples were obtained from upper arm veins and serum VEGF was determined. We determined correlation between serum VEGF and arterial oxygen saturation and compared levels of serum VEGF among groups. In addition, age and hemodynamic variables derived from cardiac catheterization were analyzed in terms of correlation with serum VEGF.
Results:
Serum VEGF significantly negatively correlated with arterial oxygen saturation (r = -0.62, p < 0.0001). Serum VEGF in B and D were significantly higher than those in A and C (median = 443 pg/mL in B and 302 pg/mL in D vs 180 pg/mL in A and 216 pg/mL in C, respectively). Serum VEGF was significantly negatively correlated with patient's age (p = 0.54, p < 0.04) in D, but significantly positively correlated with systemic venous pressure (p = 0.45, p < 0.01) in pooled data.
Conclusions:
Patients with C-CHD have increased serum VEGF in parallel with the degree of cyanosis. With biventricular repair, cyanosis and serum VEGF are normalized. However, with a Fontan type operation, cyanosis disappears but serum VEGF may not be normalized because of elevated venous pressure in association with younger age.
