Low concentrations of VEGF-C: a negative prognostic factor

A study revealed that low a concentration of vascular endothelial growth factor C (VEGF-C) at admission in patients with acute heart failure (HF) was associated with a high 1-year mortality rate.

To evaluate the role of VEGF-C, Dr Gracjan Iwanek (Wroclaw Medical University,  Poland) measured VEGF-C serum levels on admission and at discharge in 237 patients hospitalised for acute HF and assessed its influence on their prognosis. The study population was stratified into tertiles based on baseline VEGF-C level: low, medium, and high.

The group with low VEGF-C on admission showed a significant increase in serum levels during hospitalisation (median from 33 pg/mL [95% CI 15–175] to 465 pg/mL [95% CI 327–648], P<0.001), whereas the VEGF-C level did not change during the hospital stay of the medium group (median 606 pg/mL [469–741] to 645 pg/mL [365–907], P=0.21). In contrast, there was a significant drop in serum VEGF-C levels in the high VEGF-C group (from 1,141 pg/mL [95% CI 967–1,443] to 704 pg/mL [95% CI 477–1,009], P<0.001). Thus, VEGF-C serum levels from different tertiles on admission shifted in a common direction.

The 1-year mortality rate was highest in the ‘low’ VEGF-C tertile (35%) and lower in the other 2 tertiles (28% in the ‘medium’ tertile and 18% in the ‘high’ tertile; P=0.048). The same pattern was observed for a composite endpoint of death and acute HF re-hospitalisation. The corresponding numbers were 45% in the ‘low’ tertile compared with 43% and 26% in the ‘medium’ and ‘high’ tertile, respectively (P=0.012).

To shed light on the pathophysiology behind the VEGF-C release, Dr Iwanek also assessed different cardiovascular biomarkers and molecules responsible for cellular adhesion. VEGF-C concentrations at admission showed no association with NT-proBNP, creatinine, or troponin but there was an association with molecules responsible for cellular adhesion (like galectin-3, selectin, and ICAM-1) and communication.

These results further hint at the relationship of VEGF-C with peripheral tissue congestion. Therefore, its use as an indicator of peripheral congestion may be justified.

1. Iwanek G, et al. Vascular endothelial growth factor C as a potential biomarker of peripheral tissue congestion in acute heart failure. Session E-posters in acute heart failure, Heart Failure 2023, 20–23 May, Prague, Czechia.

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Posted on 8 August 202318 March 2024