Cardiac rehabilitation may influence leptin and VEGF A crosstalk in patients after acute coronary syndrome

Abstract

Leptin, a well-proven cardiovascular risk factor, influences vascular endothelial growth factor A (VEGF A) synthesis via hypoxia-inducible factor 1 alpha (HIF-1A), nuclear factor kappa-light-chain-enhancer of activated B cells (NfkB) and NILCO (Notch, interleukin 1 [IL1] and leptin cross-talk outcome) pathways. This study aimed to investigate the influence of cardiac rehabilitation (CR) on HIF-1A, NfkB and NILCO dependent leptin and VEGF A cross-talk in patients after acute coronary syndrome (ACS). Fifty post-ACS patients underwent a 2-week CR programme (study group S) and were compared to 50 post-ACS subjects who did not undergo CR (control group K). In group S, at baseline and at completion and in group K once, anthropometric, body composition, blood pressure and heart rate measurements were taken and blood sampling was performed. Serum levels of leptin, VEGF A, VEGF receptor 2 (VEGF R2), HIF-1A, NfkB, interleukin 1-alpha (IL1-alpha) and Notch 1 were determined. In group S, serum VEGF A levels increased while leptin, HIF-1A and VEGF R2 levels decreased and completion but not baseline serum leptin correlated positively with serum VEGF A. Also, serum completion VEGF A correlated positively with NfkB and HIF-1A in group S. Correlation analysis in group S confirmed the significant role of the NILCO pathway in the regulation of VEGF A serum levels mediated by HIF-1A and NfkB. CR may induce the predomination of the NILCO pathway interacting with HIF-1A and NfkB over leptin canonical and non-canonical signalling pathways in the leptin influence on VEGF A in post-ACS patients.Trial registration: ClinicalTrials.gov ID: NCT03935438. The CARDIO-REH randomised study.

Leptin–VEGF crosstalk in excess body mass and related disorders: A systematic review

“…In the study of Alqaderi et al, levels of leptin and VEGF in saliva were found not to be good predictors of obesity or hyperglycemia in adolescents 123 . Our own studies have shown that cardiac rehabilitation can decrease serum leptin and HIF‐1A levels in patients who have undergone acute coronary syndrome 124 …”

“…[112][113][114][115] Studies of patients with obesity have confirmed the genetic or epigenetic aspect of leptin-VEGF crosstalk, pointing to the role of obesity-dependent leptin gene regulation. [104][105][106][107] These studies have also revealed that leptin-VEGF crosstalk is a complicated network, involving leptin canonical and noncanonical signaling pathways, HIF-1A, and NfkB as the core, 97,124,136 with a range of substances (including adiponectin, visfatin, ghrelin, IL-6, insulin, cholesterol, LDL, triglycerides, ApoB, trimethylamine N-oxide, and NO) acting as accompanying, modifying, and disrupting factors. [99][100][101] In female patients with excess body mass and related disorders, leptin-VEGF crosstalk may be involved in PCOS, adverse pregnancy outcome, 129 and preeclampsia.…”

“…123 Our own studies have shown that cardiac rehabilitation can decrease serum leptin and HIF-1A levels in patients who have undergone acute coronary syndrome. 124 Research in obstetrics and gynecology investigating the associations between leptin and VEGF in relation to excess body mass and related disorders have also been performed. In patients with polycystic ovary syndrome (PCOS) with obesity, the serum leptin level is lower than in normo-ovulatory women with obesity, whereas VEGF levels are almost four times higher.…”

The Role of Carotid-Femoral Pulse Wave Velocity in a Metabolic Syndrome Patient with Sudden Cardiac Arrest: A Case Report

“…All these studies proved that PWV is one of the key factors influencing cardiovascular risk in patients with subclinical MetS. Recently, Skrypnik et al indicated that the implementation of the cardiac rehabilitation programme can lead to a decrease in serum leptin levels [14], which can influence arterial stiffness [15].…”