Physiologically assessed coronary collateral flow and intracoronary growth factor concentrations in patients with 1-to 3-vessel coronary artery disease
Physiologically assessed coronary collateral flow and intracoronary growth factor concentrations in patients with 1-to 3-vessel coronary artery disease
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DOI：
10.1161/01.cir.100.19.1945
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发表时间：
1999-11-09
期刊：
影响因子：
37.8
通讯作者：
Seiler, C
中科院分区：
文献类型：
--
作者：
Fleisch, M;Billinger, M;Seiler, C
背景--这项研究的目的是验证侧支循环与冠状动脉内碱性成纤维细胞生长因子和血管内皮生长因子的浓度之间存在关系的假设，以及生长因子和冠状动脉病变程度的联合浓度在这种相关性中起到的协变量作用的假设。方法和结果-在76名接受球囊血管成形术的患者中，侧支循环指数(CFI，无单位)被用传感器尖端的导丝确定。同时测定主动脉根部侧支冠脉开口处(n=76)和闭塞冠脉远端处(n=34)的血清bFGF和VEGF浓度。CFI与远端血管内皮细胞生长因子浓度呈正相关(r=0.33，P=0.05)，而与bFGF值无关。聚焦于近端采样部位，CFI与碱性成纤维细胞生长因子(r=0.29，P=0.0001)和血管内皮生长因子(r=0.44，P<；0.0001)呈正相关。两种生长因子的浓度之和与CFI直接相关，无论是近端(r=0.51P<；0.0001)还是远端(r=0.34，P=0.048)。冠脉狭窄数目越多的患者，其近端的血管内皮生长因子水平越高(r=0.25，P=0.03)。结论：在冠心病患者中，直接测量的侧支循环血流指数与冠状动脉内bFGF和血管内血管内皮生长因子的浓度有关。这种直接关系取决于冠脉树内采血的位置。当考虑到bFGF和VEGF的浓度组合时，这种关联最密切。在血管内皮生长因子的情况下，它受到冠状动脉粥样硬化程度的影响。
Background-The purpose of this study was to test the hypothesis that there is a relation between collateral flow and intracoronary concentrations of basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF) and that the combined concentrations of both growth factors and the extent of coronary artery disease (CAD) play a role as covariables in such an association.Methods and Results-In 76 patients undergoing balloon angioplasty, a collateral flow index (CFI, no units) was determined with sensor-tipped guidewires. Simultaneously, serum concentrations of bFGF and VEGF, obtained at the aortic root from the ostium of the collateralized coronary artery (n = 76) and from the distal position of the occluded coronary artery (n = 34), were determined. There was a direct correlation between CFI and distal VEGF (r = 0.33, P = 0.05) but not bFGF concentrations. Focusing on the proximal sampling site, there was a direct correlation between CFI and both bFGF (r = 0.29, P = 0.01) and VEGF concentrations (r = 0.44, P < 0.0001). The sum of the concentrations of both growth factors was directly associated with CFI irrespective of the proximal (r = 0.51, P < 0.0001) or distal sampling site (r = 0.34, P = 0.048). There was a trend toward higher proximal VEGF concentrations in patients with higher numbers of coronary stenotic lesions (r = 0.25, P = 0.03).Conclusions-In patients with CAD, there is an association between a directly measured index of collateral flow and intracoronary concentrations of bFGF and VEGF. This direct relation is dependent on the site of blood sampling within the coronary artery tree. The association is closest when the combined bFGF and VEGF concentrations are taken into account. In the case of VEGF, it is influenced by the degree of coronary atherosclerosis.