A Predictor of Collateral Formation in Congenital Heart Diseases,YASSER H. KAMEL, YASSER M. BAGHDADY and MOHAMAD SHEHATA
Abstract
Objective: Vascular endothelial growth factor is potent stimulators of angiogenesis. Children with cyanotic congenital heart disease often experience the development of widespread formation of collateral blood vessels, which may represent a form of abnormal angiogenesis resulting in increased morbidity and mortality.
The Aim of this Study: To determine whether children with cyanotic congenital heart disease have elevated serum levels of vascular endothelial growth factor compared to children with acyanotic heart disease.
Methods: Serum was obtained from 44 children with cyanotic congenital heart disease and 36 children with acyan-otic heart disease. Vascular endothelial growth factor levels were measured in the serum of these patients by sandwich enzyme immunoassay.
Results: Vascular endothelial growth factor was signifi-cantly elevated in children with cyanotic congenital heart disease compared to children with acyanotic heart disease (159.3±48.1pg/ml Vs. 85.4±18.7pg/ml, respectively, p<0.00 1). In the cyanotic group, oxygen saturation (SaO2) was negatively correlated with VEGF (r=–0.531, p<0.001) while hemoglobin was positively correlated (r=0.781, p=0.007). No significant correlations were found in the acyanotic group.
Conclusion: Children with cyanotic congenital heart disease have elevated systemic levels of vascular endothelial growth factor directly related to the degree of cyanosis (SaO2 and hemoglobin levels). These findings suggest that the widespread formation of collateral vessels in these children may be mediated by vascular endothelial growth factor.