Imbalanced Angiogenesis in Peripartum Cardiomyopathy　― Diagnostic Value of Placenta Growth Factor ―

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  • Mebazaa Alexandre
    UMR-S 942 INSERM, Lariboisière Hospital Paris Diderot University, Sorbonne Paris Cité Department of Anaesthesiology and Critical Care, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris
  • Seronde Marie-France
    UMR-S 942 INSERM, Lariboisière Hospital Department of Cardiology EA3920, University Hospital Jean Minjoz
  • Gayat Etienne
    UMR-S 942 INSERM, Lariboisière Hospital Paris Diderot University, Sorbonne Paris Cité Department of Anaesthesiology and Critical Care, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris
  • Tibazarwa Kemi
    Hatter Institute for Cardiovascular Research in Africa and MRC Inter-Cape Heart Unit, Department of Medicine, Faculty of Health Sciences, University of Cape Town Soweto Cardiovascular Research Unit, University of the Witwatersrand
  • Anumba Dilly O.C.
    Gynecology, Obstetric, Academic Unit of Reproductive and Developmental Medicine, The University of Sheffield Medical School
  • Akrout Najla
    UMR-S 942 INSERM, Lariboisière Hospital Department of Anaesthesiology and Critical Care, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris
  • Sadoune Malha
    UMR-S 942 INSERM, Lariboisière Hospital Paris Diderot University, Sorbonne Paris Cité
  • Sarb Jamela
    Gynecology, Obstetric, Academic Unit of Reproductive and Developmental Medicine, The University of Sheffield Medical School
  • Arrigo Mattia
    UMR-S 942 INSERM, Lariboisière Hospital Department of Anaesthesiology and Critical Care, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris
  • Motiejunaite Justina
    UMR-S 942 INSERM, Lariboisière Hospital Department of Anaesthesiology and Critical Care, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris
  • Laribi Said
    UMR-S 942 INSERM, Lariboisière Hospital Department of Emergency Medicine, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris
  • Legrand Matthieu
    UMR-S 942 INSERM, Lariboisière Hospital Paris Diderot University, Sorbonne Paris Cité Department of Anaesthesiology and Critical Care, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris
  • Deschamps Lydia
    Department of Pathology, Bichat Hospital, AP-HP
  • Fazal Loubina
    UMR-S 942 INSERM, Lariboisière Hospital Paris Diderot University, Sorbonne Paris Cité
  • Bouadma Lila
    Department of Medical ICU, Bichat Hospital, AP-HP
  • Collet Corinne
    Biochemistry Department, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris
  • Manivet Philippe
    UMR-S 942 INSERM, Lariboisière Hospital Biochemistry Department, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris
  • Solal Alain Cohen
    UMR-S 942 INSERM, Lariboisière Hospital Paris Diderot University, Sorbonne Paris Cité Department of Cardiology, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris
  • Launay Jean-Marie
    UMR-S 942 INSERM, Lariboisière Hospital Biochemistry Department, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris Paris Descartes University
  • Samuel Jane-Lise
    UMR-S 942 INSERM, Lariboisière Hospital Paris Diderot University, Sorbonne Paris Cité Department of Anaesthesiology and Critical Care, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris
  • Sliwa Karen
    Hatter Institute for Cardiovascular Research in Africa and MRC Inter-Cape Heart Unit, Department of Medicine, Faculty of Health Sciences, University of Cape Town Soweto Cardiovascular Research Unit, University of the Witwatersrand

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<p>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.</p><p>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).</p><p>Conclusions:Plasma of PPCM patients shows imbalanced angiogenesis. High PlGF and/or low sFlt-1/PlGF may be used to diagnose PPCM.</p>

Journal

  • Circulation Journal

    Circulation Journal 81 (11), 1654-1661, 2017

    The Japanese Circulation Society

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