| Objective:To detect the relationship between VEGF and the formation and development of pulmonary artery pressure(PH) in congenial heart dise-ases(CHD) with left-to-right shunt by measuring serum VEGF before and after intervention.Methods:50 patients (24 males and 26 females) who underwent interv-enetional occlusion successfully were enrolled, including 22 subjects with atrial septal defects (ASD),11 subjects with ventricular septal defects(VSD) and 17 subjects with ductus arteriosus(PDA). Average age was 31.6±11.58 (9-54) years. Those with hypertension, heart failure, diabetes, intravenous anesthesia, hepatic and renal dysfunction, cancer, pregnancy and lactation were excluded. During right heart catheterization, the pressure of arranged sites in cardiac cavities and pulmonary artery were measured and blood sa-mples were abstracted to calculate shunt flow. Patients were divided into three age and sex matched groups according to pulmonary artery pressure: 18 patients in normal pulmonary artery pressure group(mPAP≤25mmHg), 20 patients in mild pulmonary hypertension group (2535mmHg).27 healthy subjects (15males and 12females) with an average age of 29.0±9.7 (21-53) years were chosen as the control group. Serum lev-els of vascular endothelial growth factor were measured before and 1 hour, 24 hours and 30 days after intervention.2ml peripheral venous blood sam-ple were abstracted and stored in serum separation tubes.After agglutination for 30 minutes, they were centrifuged (1000 g×15 minutes) immediately. Then the separated serum were put into Eppendorf tubes and stored in-70℃ refrigerator. The serum levels of human vascular endothelial growth factor were measured by double antibody sandwich ABC-ELISA method. The kit was provided by Shanghai xitang biotechnology company. Statistics analys-is were carried out by SPSS 17.0 software package. Data were expres sed as mean±SD.Comparisons between two groups were examined by t-test.Com-parisons among three groups were examined by ANOVA. P<0.05 was considered statistically significant. Correlations between VEGF and pulmo-nary arterial pressure, together with left to right shunted flow were analyz-ed.Results:The serum levels of VEGF showed no significant difference between normal pulmonary arterial pressure group (105.06±56.06pg/ml) and the control group (75.90±52.83pg/ml) (P>0.05);but that in the pulmon-ary hypertension group increase notably, comparing to the control group. VEGF in the mild pulmonary hypertension group (134.32±57.82pg/ml) was much higher than the control group (75.90±52.83pg/ml) (P<0.05), moreov-er, the moderate-severe pulmonary hypertension group (193.36±61.51)pg/ ml was higher then the control group (75.90±52.83 pg/ml) (P<0.01).There was no significant difference between 1h and 24h after transcatheter patch occlusion.There was significant difference between 30 days after interventi-on and before intervention(P<0.01), which showed that VEGF began to decrease 24 hours after intervention.Correlation analysis showed that serum VEGF levels was positively correlated to left to right shunt flow and negat-ively correlated to pulmonary artery pressure in congenital heart disease.Conclusion:1.Serum VEGF levels increased in patients with congeni-tal heart disease, which suggested that VEGF may play an important role in pulmonary hypertension caused by pulmonary vascular remodeling seconda-ry to congenital heart disease.2.Serum VEGF levels increased with the shu-nt flow of CHD with left-to-right shunt, which suggested that the increase of pulmonary blood flow may cause VEGF changes.3.Among patients with congenital heart disease underwent intervention, VEGF was positively corr-elated with PH.4.VEGF started to decline 24 hours after intervention and decreased significantly after one month. The increase of VEGF was reversi-ble, indicating that interventional therapy of congenital heart disease can effectively improve PH.
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