Some patients with heart disease may not be able to grow new blood vessels around blocked arteries because they can not make enough a vital protein, according to a report in the latest issue of traffic . If confirmed by larger trials, the discovery could lead to a diagnostic test that will help cardiologists identify and treat high-risk patients.
When an artery supplying blood to the heart is blocked, the ship can sometimes build another route around the backup, a process called angiogenesis. But only about half of all patients are able to grow these new vessels.
Suspecting a difference in the expression of the VEGF gene could explain the heart of variable capacity to build its own bypass vessels, Andrew Levy and colleagues at the Technion-Israel Institute of Technology in Haifa, Israel used angiography images to classify patients with heart disease 51 into three groups depending on the number of new blood vessels their arteries were being grown to a shoe. They then measured the expression of VEGF in a patient collecting blood cells called monocytes, which are supposed to be involved in angiogenesis. A low oxygen environment - comparable to a vessel wall does not receive enough blood - cells caused by patients with a high score of angiogenesis to more than three times more RNA of VEGF
So VEGF levels appear to provide. a good way to measure whether a patient will be able to grow these new blood vessels, said Levy, and his group hopes to develop a blood test that will help VEGF cardiologists know how to treat their patients. If a patient is able to make more VEGF, "indicating that we could treat more conservatively with medications," while those who have little VEGF might be better candidates for bypass surgery, they say it.
"the potential diagnostic applications are interesting, but much more work needs to be done," said William Li, president and medical director of the Angiogenesis Foundation in Cambridge, Massachusetts. More importantly, the study should be repeated with a larger group of patients, he said, but added that researchers can not yet rule out the possibility that some patients can not do enough VEGF receptors. He said the results are also of crucial importance to Genentech and other biotechnology companies today are conducting clinical trials of VEGF therapy.
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