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Imbalanced angiogenesis in peripartum cardiomyopathy: diagnostic value of placenta growth factor
Mebazaa, Alexandre Seronde, Marie-France Gayat, Etienne Tibazarwa, Kemi Anumba, Dilly O. C. Akrout, Najla Sadoune, Malha Sarb, Jamela Arrigo, M. Motiejunaite, Justina
Mebazaa, Alexandre
Seronde, Marie-France
Gayat, Etienne
Tibazarwa, Kemi
Anumba, Dilly O. C.
Akrout, Najla
Sadoune, Malha
Sarb, Jamela
Arrigo, M.
Motiejunaite, Justina
Author
Mebazaa, Alexandre
Seronde, Marie-France
Gayat, Etienne
Tibazarwa, Kemi
Anumba, Dilly O. C.
Akrout, Najla
Sadoune, Malha
Sarb, Jamela
Arrigo, M.
Motiejunaite, Justina
Laribi, Said
Legrand, Matthieu
Deschamps, Lydia
Fazal, Loubina
Bouadma, Lila
Collet, Corinne
Manivet, Philippe
Solal, Alain Cohen
Launay, Jean-Marie
Samuel, Jane-Lise
Sliwa-Hahnle, Karen
Seronde, Marie-France
Gayat, Etienne
Tibazarwa, Kemi
Anumba, Dilly O. C.
Akrout, Najla
Sadoune, Malha
Sarb, Jamela
Arrigo, M.
Motiejunaite, Justina
Laribi, Said
Legrand, Matthieu
Deschamps, Lydia
Fazal, Loubina
Bouadma, Lila
Collet, Corinne
Manivet, Philippe
Solal, Alain Cohen
Launay, Jean-Marie
Samuel, Jane-Lise
Sliwa-Hahnle, Karen
Abstract
Background:
Concentrations of the anti-angiogenic factor soluble fms-like tyrosine kinase-1 (sFlt-1) are altered in peripartum cardiomyopathy (PPCM). In this study we investigated changes in the angiogenesis balance in PPCM.
Methods and Results:
Plasma concentrations of sFlt-1 and the pro-angiogenic placenta growth factor (PlGF) were determined in patients with PPCM during the post-partum phase (n=83), in healthy women at delivery (n=30), and in patients with acute heart failure (AHF; n=65). Women with cardiac failure prepartum or associated with any form of hypertension, including pre-eclampsia, were excluded. Compared with non-pregnant women, in women with AHF and PPCM, median PlGF concentrations were greater (19 [IQR 16–22] and 98 [IQR 78–126] ng/mL, respectively; P<0.001) and the sFlt-1/PlGF ratio was lower (9.8 [6.6–11.3] and 1.2 [0.9–2.8], respectively; P<0.001). The sFlt-1/PlGF ratio was lower in PPCM than in normal deliveries (1.2 [0.9–2.8] vs. 94.8 [68.8–194.1], respectively; P<0.0001). The area under the curve for PlGF (cut-off value: 50ng/mL) and/or the sFlt-1/PlGF ratio (cut-off value: 4) to distinguish PPCM from either normal delivery or AHF was >0.94. Median plasma concentrations of the anti-angiogenic factor relaxin-2 were lower in PPCM and AHF (0.3 [IQR 0.3–1.7] and 0.3 [IQR 0.3–1] ng/mL, respectively) compared with normal deliveries (1,807 [IQR 1,101–4,050] ng/mL; P<0.001).
Conclusions:
Plasma of PPCM patients shows imbalanced angiogenesis. High PlGF and/or low sFlt-1/PlGF may be used to diagnose PPCM.
Keywords
Angiogenesis, Peripartum cardiomyopathy (PPCM), Placental growth factor, Relaxin-2
Date
2017
Type
Journal article
Journal
Circulation Journal
Book
Volume
81
Issue
11
Page Range
1654-1661
Article Number
ACU Department
Collections
Relation URI
Source URL
Event URL
Open Access Status
License
File Access
Controlled