Vascular endothelial growth factor in children with congenital heart disease
Vascular endothelial growth factor in children with congenital heart disease
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DOI：
10.1016/s0003-4975(02)04814-2
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发表时间：
2003-05-01
影响因子：
4.6
通讯作者：
Hasegawa, T
中科院分区：
文献类型：
--
作者：
Ootaki, Y;Yamaguchi, M;Hasegawa, T
背景紫绀型先天性心脏病患儿可能会出现血管异常，这是一个重要的发病原因。这些儿童的异常血管增生可能有几种形式，包括体-肺侧支动脉、体-肺静脉侧支、双向腔静脉吻合后的体静脉侧支通道和肺动静脉畸形。然而，尚未确定对这些异常情况负责的实体。本研究旨在探讨紫绀型先天性心脏病患儿血清血管内皮生长因子（VEGF）水平是否升高，以及VEGF水平升高是否与这些异常血管相关。术前测量平均全身室内空气氧饱和度（SpO（2））、血细胞计数（RBC）和血清VEGF水平。样本取自61例非紫绀型心脏病（N组）和102例紫绀型心脏病（C组）患儿心脏手术前。C组于术后1个月行导管检查，观察病变血管情况。与N组（203.0 +/- 221.6 pg/mL; p < 0.001）相比，C组（355.0 +/- 287.1 pg/mL）的VEGF水平显著升高。与其他患者相比，C组中与无脾综合征相关的单心室患者（n = 7）的VEGF水平显著升高（711.9 +/- 443.5 pg/mL）。VEGF水平与SpO 2、RBC无明显相关性。C组19.6%（20/102）的患者诊断为异常血管。血管异常患者VEGF水平（336.8 ± 182.5 pg/mL）与无血管异常患者VEGF水平（359.1 ± 306.8 pg/mL）无差异。紫绀型心脏病患儿全身VEGF水平升高，尤其是单心室伴无脾综合征的患儿。血管异常与无血管异常患者VEGF水平无明显相关性。(C)2003年由胸外科医师协会发布。
Background. Children with cyanotic congenital heart disease may experience the development of abnormal vessels that become a source of significant morbidity. Abnormal vessel proliferation in these children may take several forms, including systemic-to-pulmonary collateral arteries, systemic-to-pulmonary venous collaterals, systemic venous collateral channels after bidirectional cavopulmonary anastomosis, and pulmonary arteriovenous malformations. However, no entity responsible for these abnormalities has been identified yet. This study determined whether children with cyanotic congenital heart disease have elevated serum levels of vascular endothelial growth factor (VEGF) and whether elevated VEGF correlated with these abnormal vessels.Methods. Mean systemic room air oxygen saturation (SpO(2)), blood cell counts (RBC), and serum VEGF levels were measured preoperatively. Samples were obtained from 61 children with acyanotic heart disease (group N) and 102 children with cyanotic heart disease (group C) before cardiac surgery. Postoperative catheterization was performed 1-month after the operation to evaluate the abnormal vessels in group C.Results. The VEGF level was significantly elevated in group C (355.0 +/- 287.1 pg/mL) compared with group N (203.0 +/- 221.6 pg/mL; p < 0.001). VEGF levels in patients with a single ventricle associated with asplenia syndrome (n = 7) in group C were significantly elevated (711.9 +/- 443.5 pg/mL) compared with other patients. There was no significant correlation between VEGF level and SpO(2) or RBC. Abnormal vessels were diagnosed in 19.6% (20/102) patients in group C. There was no difference in VEGF levels between the patients with abnormal vessels (336.8 +/- 182.5 pg/mL) and the patients without abnormal vessels (359.1 +/- 306.8 pg/mL).Conclusions. Children with cyanotic heart disease have elevated systemic levels of VEGF, especially in those patients with a single ventricle associated with asplenia syndrome. There was no significant relationship in VEGF levels between the patients with abnormal vessels and without these vessels. (C) 2003 by The Society of Thoracic Surgeons.