Relation between the VEGF level and myocard ischemia in patients with collateral vessels and single-vessel chronic total occlusion

10.SUMMARYRELATION BETWEEN THE VEGF LEVEL AND MYOCARDISCHEMIA IN PATIENTS WITH COLLATERAL VESSELS ANDSINGLE-VESSEL CHRONIC TOTAL OCCLUSIONIntroduction and aim:Coronary collateral vessel growth is a process which is mainly induced by myocardialischemia and contributed largely by Vascular Endothelial Growth Factor (VEGF). High levelof plasma VEGF in patients with multi-vessel disease or chronic total occlusion and sufferingfrom myocardial ischemia episodes may provide valuable information about the diagnosis ofischemia. The aim of this study is to search the relation between the plasma VEGF levels andthe diseases in patients with multi-vessel diseases and ischemic complaints and chronicsingle-vessel coronary artery patients provided with distal flow by collateral vessels.Material and method:Totally 71 patients, 30 of whom with single-vessel chronic total occlusion in whichdistal flow has been maintained by means of collateral vessels in the coronary angiography(CTO group), 20 of whom with significant narrowness in more than one coronary artery(MVD group) and 21 of whom with normal coronary artery as a control group wereexamined. Patients with non-atherosclerotic disease were excluded from the study. Tc-99 mmyocard perfusion scintigraphy was applied to the patients in the CTO group for the ischemiastudy. Patients who were found to have infarct after MPS were studied in terms of myocardactivity by Tallium 201. Plasma was obtained from peripheric blood samples in all patients inthe day following angiography. VEGF plasma levels were examined with the ELISA method.Findings:The groups were similar in terms of basal patient characteristics. Only the group withnormal coronary artery had less cigarette consumption than CTO group and there were morefemale patients in the first than the latter. The average VEGF value was detected as 6,2 ± 9,1pg/ml in the total occlusion group, 6,1± 7,6 pg/ml in the normal control group and 13,4±23,7pg/ml in the multi-vessel control group. No difference was found among the three groups interms of VEGF values (p=0,2). When those who were detected to have ischemia by MPS(n=12) and those who were detected to have infarct (n=12) in the CTO group were compared,no difference was found in terms of VEGF levels. (p=0,5).Conclusion:VEGF levels obtained from peripheric blood showed no difference in coronary arterypatients with or without angiographic collateral and in normal individuals. Therefore, plasmaVEGF levels were found to have no value in the diagnosis of ischemic heart disease.