Levels of angiogenesis markers in patients with different heart failure phenotypes

Abstract

Aim. To assess the relationship between the levels of angiogenesis markers and various heart failure (HF) phenotypes in patients with class II-IV HF of ischemic origin.Material and methods. This cross-sectional cohort study was based on the clinical departments of the National Medical Research Center for Therapy and Preventive Medicine. The study involved 180 patients aged 30-85 years with class II-IV HF of ischemic origin as follows with (n=90) and without (n=90) metabolic syndrome (MS). All patients included in the study signed an informed consent to personal data processing, participation in a clinical trial and consent to blood biobanking. All patients were divided into three groups: HF with reduced ejection fraction (HFrEF) — left ventricular (LV) EF <40%, HF with mildly reduced EF (HFmrEF) — LVEF from 40 to 49%, HF with preserved EF (HFpEF) — LVEF >49%. In addition to the standard paraclinical investigations, angiogenesis markers were analyzed with the determination of transforming growth factor β (TGF-β), vascular endothelial growth factor A (VEGF-A), pentraxin-3 (PTX-3). Statistical analysis was performed using Microsoft Office Excel, STATISTICA 10.0 software packages (Statsoft, USA).Results. Transthoracic echocardiography determined that 74 (41,1%) patients had LVEF <50%, while 71 (39,4%) — <40%. For the group of patients with HFpEF, there was an association with an increase in TGF-β ≥7,2 ng/ml (p=0,011). The threshold level of PTX-3 ≥55 ng/ml is associated with the development of HFpEF (p=0,001). For the HFmrEF phenotype, the threshold values of VEGF-A, TGF-β and PTX-3 were determined, which did not reach the significance level. However, an upward trend in VEGF-A >200 ng/ml was noted (p=0,052). In HFrEF patients, a threshold value of VEGF-A >195 ng/ml (p=0,001) associated with reduced LVEF was determined.Conclusion. Thus, the present work showed the relevance of using PTX-3, VEGF-A and TGF-β as additional markers for assessing the HF course. So, patients with HFpEF had increased levels of PTX-3 and TGF-β, while patients with HFmrEF and HFrEF — increased VEGF-A values. Determination of the level of these angiogenesis markers should be used to improve the efficiency of diagnosis and treatment of patients with various class II-IV HF phenotypes.

Keywords

• маркеры ангиогенеза
• фенотипы
• хроническая сердечная недостаточность