Increased levels of Angiogenic Factors In Microvascular Angina

Abstract

Background. Recent studies have suggested that angiogenic factors may affect vascular endothelial integrity. On the other hand, endothelial dysfunction is the main pathological mechanism in microvascular angina (MVA) or cardiac syndrome X. Therefore, we aimed to determine the levels of angiogenic factors in MVA patients. In addition, we investigated the effects of metoprolol, as a beta blocker agent, on the serum levels of these factors.Methods. Thirty patients with MVA (17 female/13 male; mean age: 55.53±9.18 years) and twenty healthy controls (14 female/6 male; mean age: 51.40±9.16 years) were enrolled.The serum amounts of angiopoietin-1 (Ang-1), angiopoietin-2 (Ang-2) and tyrosine kinase-2 receptor (Tie-2) were measured in healthy controls, MVA patients at baseline and after metoprolol therapy (25 mg for one month) by enzyme-linked immunosorbent assay.Results. The levels of Ang-2 and Tie-2 were significantly higher in MVA patients at baseline in comparison with controls (Ang-2: 277.02±186.08 vs.164.46±49.83 ng/l, P=0.011; Tie-2: 28.97±18.85 vs. 14.90±4.05 ng/ml, P=0.002; respectively). But this difference in the Ang-1 levels was not significant (P=0.829). Additionally, the levels of angiogenic factors in MVA patients after metoprolol therapy were not significantly changed in comparison with the baseline status (P>0.05).Conclusion. Our results considered a possible role for angiogenic factors in the pathophysiology of MVA, which need ‎further investigation for elucidation. In addition, this study has not showed an effective role for metoprolol in changing the angiogenic factors levels as a therapeutic agent in MVA.

Biomarkers of Coronary Microvascular Dysfunction in Patients With Microvascular Angina: A Narrative Review

“…39,40 Moreover, angiogenic factors have been investigated for their possible role in affecting endothelial function and integrity, leading to CMD and MVA. Asl et al 41 measured angiogenic factors levels in 30 MVA patients and 20 healthy controls; they found that the patients had significantly higher levels of Angp-2 and Tie-2 than controls. Afterward, patients with MVA underwent 4 weeks of metoprolol therapy, and at the end of this period, no significant changes were found in the levels of angiogenic factors compared with baseline values.…”

Circulating Biomarkers in Coronary Microvascular Dysfunction

“…Single studies have reported higher levels of serotonin, 75 stearic acid, 76 ornithine, 76 cardiac bridge integrator 1, 77 galactin‐3, 14 galectin‐4, 34 angiopoietin‐2 and tyrosine kinase‐2 receptor, 78 lymphocyte DNA damage, 79 NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide), 62 and red blood cell distribution width 62 in CMD compared with control subjects, and no difference in apolipoprotein‐C levels in CMD compared with controls. 31 In a study of 97 subjects with CMD, galectin‐4 levels correlated with myocardial blood flow reserve.…”