Effect of intra-arterial heparin flushing (IAHF) to prestin and vascular endothelial growth factor (VEGF) level in hearing loss patients

Abstract

Background: According to the World Health Organization (WHO), hearing loss is the fourth largest disability globally, affecting an estimated 466 million people in 2018. In Indonesia, the prevalence of hearing loss was estimated at 16.8% in 2016. Intra-Arterial Heparin Flushing (IAHF) is an endovascular technique that uses heparin to promote reperfusion and increases Vascular Endothelial Growth Factor (VEGF) expression. VEGF is a polypeptide angiogenesis factor present in the nervous system, which functions as a neurotrophic and neuroprotective. Meanwhile, prestin is a protein of outer ear hair cells that shows early signs of hearing loss through increased levels in cases of ear hair cell damage. Objective: This study aims to evaluate the effect of IAHF on prestin and VEGF levels in hearing-impaired patients. Methods: The design is experimental with Pre-Post Test One-Group Only. A total of 22 patients with hearing loss were measured for prestin and VEGF before and 4 hours after the IAHF procedure. Results: The results of the Wilcoxon test showed no significant differences in prestin level (p=0.658) and VEGF level (p=0.291) before and after the IAHF procedure. The mean showed an insignificant decrease in prestin level before and after the IAHF procedure with values of 1,185+1,229 pg/mL and 1,096+1,183 pg/mL, respectively. However, the VEGF level insignificantly increased before and after the procedure with values of 484.83+274.6 pg/mL and 498.79+257.7 pg/mL, respectively. Conclusion: There were no significant differences in prestin and VEGF levels before and after the IAHF procedure. However, there was a decrease in the prestin level and an increase in the VEGF level.