Relationship Between VEGF-C Levels and All-cause Mortality in Patients with Chronic Heart Failure

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Topic: Heart Failure (Clinical), Cardiomyopathy, Myocarditis

The lymphatic system has been suggested to play an important role in cardiovascular disease. Vascular endothelial growth factor-C (VEGF-C) plays a key role in lymphangiogenesis. However, the relationship between VEGF-C levels and mortality in patients with chronic heart failure is unknown.

We performed a prospective cohort study involving a total of 220 symptomatic patients with chronic heart failure. Patients were followed up over 4 years. The outcome was all-cause death. Serum levels of VEGF-C were measured at the baseline. Patients were divided into two groups based on the median of VEGF-C levels. During the follow-up, a total of 59 patients (26.8%) died from any cause. In Kaplan-Meier analysis, the low-VEGF-C group had a significantly higher risk of all-cause death compared with the high-VEGF-C group (p=0.003 by log-rank test). Furthermore, multivariate Cox proportional hazard analysis revealed that the VEGF-C level was significantly and inversely associated with the risk of all-cause death after adjustment for established risk factors (i.e. age, sex, the body mass index, hypertension, diabetes, previous heart failure hospitalisation, coronary artery disease, persistent/permanent atrial fibrillation, chronic kidney disease, anaemia, and a reduced left ventricular ejection fraction [<50 %]) (adjusted hazard ratio, 0.72 for 1-SD increase; 95 % CI [0.52–0.99]; p=0.04).

In conclusion, a low VEGF-C value was independently associated with the risk of all-cause mortality in patients with chronic heart failure.