Relationship between vascular endothelial growth factor and left ventricular dimension in patients with acute myocardial infarction

Changes in gene expression patterns in postmortem human myocardial infarction

In murine models, the expression of inducible nitric oxide synthase (iNOS) in myocardial infarction (MI) has been reported to be the result of tissue injury and inflammation. In the present study, mRNA expression of iNOS, hypoxia-inducible factor-1α (HIF-1α), and vascular endothelial growth factor (VEGF) was investigated in postmortem human infarction hearts. Since HIF-1α is the inducible subunit of the transcription factor HIF-1, which regulates transcription of iNOS and VEGF, the interrelation between the three genes was observed, to examine the molecular processes during the emergence of MI. iNOS and VEGF mRNAs were found to be significantly upregulated in the affected regions of MI hearts in comparison to healthy controls. Upregulation of HIF-1α was also present but not significant. Correlation analysis of the three genes indicated a stronger and significant correlation between HIF-1α and iNOS mRNAs than between HIF-1α and VEGF. The results of the study revealed differences in the expression patterns of HIF-1 downstream targets. The stronger transcription of iNOS by HIF-1 in the affected regions of MI hearts may represent a pathological process, since no correlation of iNOS and HIF-1α mRNA was found in non-affected areas of MI hearts. Oxidative stress is considered to cause molecular changes in MI, leading to increased iNOS expression. Therefore, it may also represent a forensic marker for detection of early changes in heart tissue.

Serum vascular endothelial growth factor level is elevated in patients with impaired glucose tolerance and type 2 diabetes mellitus

Objective

This study was performed to investigate the serum vascular endothelial growth factor (VEGF) levels in Chinese patients with impaired glucose tolerance (IGT) and newly diagnosed type 2 diabetes mellitus (T2DM).

Methods

A total of 189 subjects (41 controls, 40 patients with IGT, and 108 patients with newly diagnosed T2DM) were recruited. Serum VEGF levels were determined by ELISA; other metabolic parameters were assessed by standard laboratory methods.

Results

There were significant differences in serum VEGF levels among the T2DM, IGT, and control groups (T2DM vs. controls: 72.00 [45.40, 98.35] pg/mL vs. 53.10 [36.30, 116.25] pg/mL; IGT vs. controls: 78.17 [55.52, 137.25] pg/mL vs. 53.10 [36.30, 116.25] pg/mL). Moreover, serum VEGF levels were positively associated with the homeostasis model assessment for insulin resistance (HOMA-IR) value. Multiple linear regression analysis indicated that the HOMA-IR value was an independent risk factor for elevated serum VEGF level.

Conclusions

Both IGT and T2DM patients exhibited increased serum VEGF levels, compared with controls; increased serum VEGF level was positively associated with the HOMA-IR value. Therefore, the increased serum VEGF level might partially result from increased insulin resistance in these patients.

Cytokines profile of reverse cardiac remodeling following transcatheter aortic valve replacement

OBJECTIVE

Previous studies have suggested that cytokines and growth factors may predict ventricular recovery following aortic valve replacement (AVR). The primary objective of this study was to identify cytokines that predict ventricular recovery following transcatheter AVR (TAVR).

METHODS

We prospectively enrolled 121 consecutive patients who underwent TAVR. Standard echocardiographic assessment at baseline, 1-month and 1-year after TAVR included left ventricular (LV) mass index (LVMI) and global longitudinal strain (GLS). Blood samples were obtained at the time of the procedure to measure cytokines using a 63-plex Luminex platform. Partial least squares-discriminant analysis was performed to identify cytokines associated with ventricular remodeling and function at baseline as well as 1 year after TAVR.

RESULTS

The mean age was 84 ± 9 years, with a majority of male subjects (59%), a mean LVMI of 120.4 ± 45.1 g/m² and LVGLS of -13.0 ± 3.2%. On average, LV mass decreased by 8.1% and GLS improved by 20.3% at 1 year following TAVR. Among cytokines assayed, elevated hepatocyte growth factor (HGF) emerged as a common factor significantly associated with worse baseline LVMI and GLS as well as reduced ventricular recovery (p < 0.005). Other factors associated with ventricular recovery included a select group of vascular growth factors, inflammatory mediators and tumor necrosis factors, including VEGF-D, ICAM-1, TNFβ, and IL1β.

CONCLUSION

We identified a network of cytokines, including HGF, that are significantly correlated with baseline LVMI and GLS, and ventricular recovery following TAVR.

Correlation between vascular endothelial growth factor and long-term prognosis in patients with acute myocardial infarction

The aim of the present study was to investigate the correlation between plasma the levels of vascular endothelial growth factor (VEGF) and major adverse cardiovascular events (MACE) in patients with acute myocardial infarction (AMI). A total of 124 patients with AMI undergoing emergency percutaneous coronary intervention (PCI) were selected, and plasma VEGF levels were measured 7 days after the onset of AMI using an enzyme-linked immunosorbent assay. The patients were divided into the L (≤190 pg/ml VEGF) and H (>190 pg/ml VEGF) groups, and were followed up every 2 months for an average of 12 months. MACE were recorded during follow-up. On the basis of these results, the patients were further divided into the MACE and non-MACE (N-MACE) groups, and the serum VEGF concentration was compared between the two groups. At the 6-month follow-up, the incidence of MACE in the H group was found to be significantly reduced compared with the L group. The serum VEGF concentration in the N-MACE group was significantly higher compared with the MACE group. Multinomial logistic regression revealed that reduced VEGF levels (β=1.243; 95% CI, 1.018-1.326; P=0.026) were independent risk factors for MACE. In conclusion, high plasma VEGF levels at 7 days after AMI onset facilitate the long-term prognosis in the same infarct zone in patients with AMI, while low plasma VEGF levels are independent risk factors for MACE.