Study On The Association Of Vascular Endothelial Growth Factor And Coronary Collateral Circulation In Patients With Chronic Total Occluded Coronary Artery Disease

Objective: To study the role of VEGF in the development of coronary collateral circulation in patients with chronic total occluded coronary artery disease and its clinical significance preliminarily.To investigate the correlation between SNPs of VEGF promoter region +405G/C and-2578C/A and coronary collateral circulation in patients with chronic total occluded coronary artery disease.Methods:The experiment adopts case-control studying method. All the cases were recruited from the First Affiliated Hospital of Wannan Medical College and surrounding counties from October 2013 to October 2014,including 40 patients with CTO and 40 cases with non-CTO.The CTO group was divided into the good CCC and the bad CCC.The expression levels of serum VEGF was detected by enzyme linked immunosorbent assay,and the genomic DNA was isolated from whole blood by using Promega Wizard Genomic DNA Purification Kit.The objective gene segment was amplificated by polymerase chain reaction sequence specific primers method,and the direct sequencing method was used to detect SNPs of VEGF promoter region +405G/C and-2578C/A in two groups.Statistical analysis was analysised by using SPSS17.0 version software package.A probability level of 5% was considered significant.Results:(1)Comparison of clinical data:Compared with non CTO group,the CTO canbe found in male patients easier.And whether it is between CTO group and non CTO group or the CTO group of good CCC and bad CCC group, there was no significant difference about agesensitivity in clinical data,especially to the traditional risk factors for coronary disease have no significant difference in the formation of CTO and CCC(P>0.05).(2)In CTO of coronary artery,the collateral blood was mainly supplied from LAD vessel with the occlusion of RCA vessel,while the collateral blood of LAD vessel occlusion was mainly supplied from RCA vessel.(3)Comparison with the level of serum VEGF:The level of serum VEGF in CTO group was significantly higher than that in non-CTO group(P<0.05),the good CCC group in CTO had high level of serum VEGF(P<0.05).The level of serum VEGF in good CCC group of LAD vessel occlusion(P<0.05).No matter CTO or good CCC,the level of serum VEGF in triple vessel disease group was higher than that in binary vessel disease group(P<0.05).(4)VEGF+405G/C:Compared with CTO and CCC groups,the genotype and allele prequencies of VEGF+405G/C were no significant difference about agesensitivity in non-CTO and bad CCC groups(P>0.05).(5)VEGF-2578C/A: Compared with CTO and CCC groups,the genotype and allele prequencies of VEGF-2578C/A were no significant difference about agesensitivity in non-CTO and bad CCC groups(P>0.05).Conclusion: 1.The CTO may be formed easier in the male patients,however they can’t form good CCC easier.2.In CTO of coronary artery,the collateral blood was mainly supplied from LAD vessel with the occlusion of RCA vessel,while the collateral blood of LAD vessel occlusion was mainly supplied from RCA vessel.3. The serum level of VEGF may be involved in the formation of CTO, even participated in the formation of CCC.And it is more conducive to form good CCC of LAD occlusion and the triple vessel disease of CTO.4.Single nucleotide polymorphisms of VEGF promoter region +405G/C and-2578C/A could be no associated with the coronary collateral circulation in patients with chronic total occluded coronary artery disease.