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

Alexandre Mebazaa; Marie-France Seronde; Etienne Gayat; Kemi Tibazarwa; Dilly O.C. Anumba; Najla Akrout; Malha Sadoune; Jamela Sarb; Mattia Arrigo; Justina Motiejunaite; Said Laribi; Matthieu Legrand; Lydia Deschamps; Loubina Fazal; Lila Bouadma; Corinne Collet; Philippe Manivet; Alain Cohen Solal; Jean-Marie Launay; Jane-Lise Samuel; Karen Sliwa

doi:10.1253/circj.CJ-16-1193

Heart Failure

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

Alexandre Mebazaa, Marie-France Seronde, Etienne Gayat, Kemi Tibazarwa, Dilly O.C. Anumba, Najla Akrout, Malha Sadoune, Jamela Sarb, Mattia Arrigo, Justina Motiejunaite, Said Laribi, Matthieu Legrand, Lydia Deschamps, Loubina Fazal, Lila Bouadma, Corinne Collet, Philippe Manivet, Alain Cohen Solal, Jean-Marie Launay, Jane-Lise Samuel, Karen Sliwa

Author information

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

Keywords: Angiogenesis, Peripartum cardiomyopathy (PPCM), Placental growth factor, Relaxin-2

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Supplementary material

2017 Volume 81 Issue 11 Pages 1654-1661

DOI https://doi.org/10.1253/circj.CJ-16-1193

Editorial (81-11 pp. 1578-1579)

Browse “Advance online publication” version

Details

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.

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