Growth factors (GFs) in pericardial fluid may reflect and modulate events such as the activation of macrophages and endothelial cells in the coronary vasculature. Such activation in turn affects angiogenesis or plaque instability. We correlated pericardial GFs with age, risk factors, cardiac conditions, medical therapy, and collateral vessels. Pericardial fluid obtained from 293 patients during open heart surgery were assayed by ELISA for the pro-angiogenic VEGF, MCP-1, TGF-B1, angiogenin (ANG), PIGF, PDGF-AB, FGF-4; and sVCAM, a marker of endothelial activation / inflammation. Coronary angiograms were assessed for collaterals and correlated with GFs and patient information. The population ranged from 18- 91 years (mean 61.9) and was 69% male. VEGF (p=0.001) and PDGF-AB (p=0.006) were found to significantly decrease with age. VEGF (p=0.005), PlGF (p=0.013), ANG (p<0.001), FGF-4 (p=0.007), and MCP-1 (p=0.033) were all found to be significantly lower (25-40%) in females. Although not statistically significant, females also had fewer collateral vessels, with 47% of females demonstrating an absence of visualized collaterals and only 35% of males in this category (p=0.143). Concentrations of s VCAM were reduced by 22% (p=0.009) in patients receiving statin therapy, while TGF-B1 exhibited a significant inverse relationship with the number of sites requiring bypass. Locally decreased angiogenic GFs in older patients and females may underlie reduced angiogenic competence, which might explain higher complications noted after MI in women. The level of sVCAM may reflect local vascular stability, while TGF-B1 may play a locally protective role with respect to the extent of atherosclerosis. We hypothesize that intrapericardial fluid analysis may provide new prognostic information with respect to angiogenesis, plaque stability, and GF management.
|Original language||English (US)|
|Journal||Journal of Investigative Medicine|
|State||Published - Feb 1999|
ASJC Scopus subject areas
- Biochemistry, Genetics and Molecular Biology(all)