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Open Access Research article

Serum VEGF levels are related to the presence of pulmonary arterial hypertension in systemic sclerosis

Andriana I Papaioannou1*, Epaminondas Zakynthinos2, Konstantinos Kostikas1, Theodoros Kiropoulos1, Angela Koutsokera1, Athanasios Ziogas3, Athanasios Koutroumpas3, Lazaros Sakkas3, Konstantinos I Gourgoulianis1 and Zoe D Daniil1

Author Affiliations

1 Department of Respiratory Medicine University of Thessaly School of Medicine, University Hospital of Larissa, Larissa 41110, Greece

2 Department of Intensive Care University of Thessaly School of Medicine, University Hospital of Larissa, Larissa 41110, Greece

3 Department of Internal Medicine, University of Thessaly School of Medicine, University Hospital of Larissa, Larissa 41110, Greece

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BMC Pulmonary Medicine 2009, 9:18  doi:10.1186/1471-2466-9-18

Published: 9 May 2009

Abstract

Background

The association between systemic sclerosis and pulmonary arterial hypertension (PAH) is well recognized. Vascular endothelial growth factor (VEGF) has been reported to play an important role in pulmonary hypertension. The aim of the present study was to examine the relationship between systolic pulmonary artery pressure, clinical and functional manifestations of the disease and serum VEGF levels in systemic sclerosis.

Methods

Serum VEGF levels were measured in 40 patients with systemic sclerosis and 13 control subjects. All patients underwent clinical examination, pulmonary function tests and echocardiography.

Results

Serum VEGF levels were higher in systemic sclerosis patients with sPAP ≥ 35 mmHg than in those with sPAP < 35 mmHg (352 (266, 462 pg/ml)) vs (240 (201, 275 pg/ml)) (p < 0.01), while they did not differ between systemic sclerosis patients with sPAP < 35 mmHg and controls. Serum VEGF levels correlated to systolic pulmonary artery pressure, to diffusing capacity for carbon monoxide and to MRC dyspnea score. In multiple linear regression analysis, serum VEGF levels, MRC dyspnea score, and DLCO were independent predictors of systolic pulmonary artery pressure.

Conclusion

Serum VEGF levels are increased in systemic sclerosis patients with sPAP ≥ 35 mmHg. The correlation between VEGF levels and systolic pulmonary artery pressure may suggest a possible role of VEGF in the pathogenesis of PAH in systemic sclerosis.