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Maternal and foetal angiogenic imbalance in congenital heart defects

Elisa Llurba1, Olga Sánchez, Queralt Ferrer

  • 1Department of Obstetrics, Maternal-Foetal Medicine Unit, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Spain.

European Heart Journal
|October 26, 2013
PubMed

Insights

Congenital heart defects (CHDs) are linked to an imbalance in angiogenic factors in maternal and fetal blood, and abnormal expression in fetal heart tissue. This suggests an intrinsic angiogenic impairment contributes to heart development issues.

Area of Science:

  • Cardiovascular Biology
  • Developmental Biology
  • Maternal-Fetal Medicine

Background:

  • Angiogenesis is crucial for normal heart development.
  • Previous animal studies suggest a link between angiogenesis and abnormal heart development.
  • Imbalances in angiogenic factors may play a role in congenital heart defects (CHDs).

Purpose of the Study:

  • To investigate the relationship between CHDs and angiogenic/anti-angiogenic factor imbalance in maternal and fetal circulation.
  • To examine the expression of angiogenic factors within the fetal heart tissue of CHD cases.

Main Methods:

  • Compared levels of placental growth factor (PlGF), soluble fms-like tyrosine kinase-1 (sFlt-1), and soluble endoglin (sEng) in maternal and cord blood of 65 CHD cases and 204 controls.
  • Analyzed expression of vascular endothelial growth factor (VEGF), sFlt-1, hypoxia markers (HIF-2α, HO-1), and antioxidant activity (SOD1) in heart tissue from 23 CHD fetuses and 8 controls.

Main Results:

  • CHD cases showed significantly lower maternal plasma PlGF and higher sFlt-1 compared to controls.
  • Fetal blood in CHD cases exhibited higher cord plasma sFlt-1 and sEng levels.
  • CHD fetal hearts displayed increased expression of VEGF, sFlt-1, and markers of chronic hypoxia and antioxidant activity.

Conclusions:

  • An intrinsic angiogenic impairment is present in CHDs, affecting both maternal and fetal circulation and the fetal heart.
  • The findings suggest an imbalance of angiogenic and anti-angiogenic factors is associated with developmental defects in the human heart.
Abstract

Keywords:
Congenital heart defectsPlacental growth factorSoluble endoglinVascular endothelial growth factorsFlt-1

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