Angiopoietin-2, Angiopoietin-1 and subclinical cardiovascular disease in Chronic Kidney Disease

Abstract

Angiopoietins (Angpt) and vascular endothelial growth factor (VEGF) have been associated with cardiovascular disease. The study enrolled 270 pre-dialysis stage 3–5 CKD patients to assess the link between circulating Angpt2, Angpt1 and VEGF-A and subclinical measures of cardiovascular structure and function. Serum markers of angiogenesis were measured using commercial enzyme-linked immunosorbent assays. Cardiac structure and function were examined by echocardiography. Brachial-ankle pulse wave velocity (baPWV) was measured by the ankle-brachial index. The adjusted mean of left ventricular mass index (LVMI) was 2.05 in patients of Angpt2 quartile 4 and 1.99 in those of Angpt2 quartile 1 (P = 0.04). Angpt2 was significantly associated with LV hypertrophy (LVH) (Angpt2 quartile 4 compared with Angpt2 quartile 1: adjusted OR: 2.68, 95% CI: 1.15–6.20). Angpt1 was negatively correlated with left atrial diameter (adjusted mean of LAD: 3.59 in Angpt1 quartile 4, 3.92 in Angpt1 quartile 1, P = 0.03). A positive and significant correlation was found between Angpt2 level and baPWV in spearman’s correlation, but not in adjusted model. In conclusion, high Angpt2 and low Angpt1 levels were positively associated with abnormal cardiac structure in stages 3–5 CKD patients, which is compatible with the viewpoint that angiopoietins participates in cardiovascular burdens.

Angiopoietin-2, Renal Deterioration, Major Adverse Cardiovascular Events and All-Cause Mortality in Patients with Diabetic Nephropathy

“…In addition, serum Angpt2 levels has been correlated with subclinical cardiovascular diseases such as fractional shortening, number of carotid plaques [21] and carotid intima media thickness [22]. In our previous reports, we found that CKD patients with high serum Angpt2 levels were more likely to have high brachial-ankle pulse wave velocity, high left ventricular mass index and left ventricular hypertrophy [23]. Serum Angpt2 was associated with abnormal cardiovascular structure, and increased cardiovascular burden.…”

The association of angiogenic factors and chronic kidney disease

“…Our study sample was found to have a similar growth factor milieu, with angiopoietin-1 deficiency relative to excess VEGF-A among CKD patients. A recent study suggested that low angiopoietin-1 level was positively associated with abnormal cardiac structure in stages 3–5 CKD patients [ 42 ]. Further studies are warranted to investigate whether imbalanced angiopoietin-1 and VEGF-A may be associated with an increased risk of ESRD and CVD in CKD patients.…”

Effects of respiratory muscle training on endothelium and oxidative stress biomarkers in hemodialysis patients: A randomized clinical trial

“…We also evaluated angiopoietin-2, a natural antagonist of angiopoietin-1, which leads to aberrant neovascularization and endothelial abnormalities [32]. Moreover, angiopoietin-2 has been recently identified as a prognostic biomarker of cardiovascular events and mortality in chronic kidney disease patients [33] and those with subclinical cardiovascular disease [34]. Together with the syndecan-1 findings, the reduced levels of angiopoietin-2 in patients submitted to training permit us to speculate that RMT has a great potential to have a positive impact on cardiovascular disease, a highly prevalent condition in hemodialysis patients.…”