Angiogenic biomarkers in children with congenital heart disease: possible implications

Abstract

BackgroundVascular endothelial growth factor (VEGF), platelet derived endothelial cell growth factor/thymidine phosphorylase (PD-ECGF/TP) and leptin are known as potent angiogenic factors The objective of the study was to evaluate these angiogenic factors VEGF, PD-ECGF/TP and leptin in children with congenital heart disease (CHD) and the factors that lead to angiogenesis in such cases.MethodsSixty CHD children were studied and divided into two groups (n = 30); cyanotic-CHD (C-CHD) and acyanotic-CHD (A-CHD). Twenty five healthy children were included as controls.ResultsSignificantly higher serum levels of VEGF, PD-ECGF/TP activity and leptin were detected in patients with CHD, particularly in patients with C-CHD. CHD patients with SpO2 <90%, pulmonary hypertension (PH), severe pulmonary stenosis (PS), detectable collaterals, cardiomegaly and/or heart failure showed significantly higher levels of these factors than those with higher SpO2 or those without these findings.ConclusionHypoxia, PH and PS are important factors that lead to harmful angiogenesis. However, angiogenesis could be essential in some cases of CHD as coarctation of aorta to enhance renal perfusion. This may provide new ways for therapeutic strategies aiming at reducing or promoting angiogenesis in CHD to improve patient's outcome.

Vasoactive mediators in congenital heart diseases with shunt lesions and pulmonary hypertension

“…A negative correlation was also found between pulmonary artery oxygen saturation and endothelin levels. These findings show that hypoxia is a strong stimulant for endothelin secretion (27)(28)(29).…”

“…These findings led us to conclude that VEGF comes into the picture in further phases of pulmonary hypertension and plays a part in structural variations that become irreversible. Accordingly, the determination of VEGF levels may also be a guide for pulmonary hypertension follow-up (11)(12)(13), and inhibition of the VEGF signaling pathway may play a role in the treatment of pulmonary hypertension (14,15).…”

Expression of Proinflammatory Factors, Proangiogenic Factors and Endostatin in Patients with Heart Failure and Different Grades of Collateral Circulation Development

“…In the study by El-Melegy et al, significantly higher VEGF levels were found in children with congenital heart disease and developed collaterals [24]. Patel et al reported that serum VEGF levels did not correlate with objective markers of left ventricular function, but were significantly lower in patients with ischemic heart disease accompanied by heart failure [25].…”

Perioperative Major Aortopulmonary Collateral Arteries (MAPCAs) Coiling in Tetralogy of Fallot Patients Undergoing for Total Correction

“…The development of MAPCAs is much more common in our patients due to chronic hypoxia and dense cyanosis due to delay of treatment as these are contributing factors [16][17][18][19]. On contrary in developed countries patients with TOF with pulmonary stenosis have usually total correction before 6 months of age [7][8][9] so the development of MAPCAs is very unlikely in these patients.…”