ArticleCirculation2016
Elevated Angiopoietin-2 Level in Patients With Continuous-Flow Left Ventricular Assist Devices Leads to Altered Angiogenesis and Is Associated With Higher Nonsurgical Bleeding.
Article in Circulation, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers, 1 of them a synthesis that pooled it.
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55 citing papers in PubMed, 1 synthesis or guideline pooled it, 148 citations in OpenAlex.
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- [Anesthesia in patients with left ventricular assist devices : Anesthesiological management of patients with permanent left ventricular assist devices during noncardiac surgery].Die Anaesthesiologie · 2025Review
- Heart Failure Readmission Prevention Strategies-A Comparative Review of Medications, Devices, and Other Interventions.Journal of clinical medicine · 2025Review
- Understanding the role of vascular stretch on modulation of VWF and ANGPT-2 in continuous flow left ventricular assist device (CF-VAD) patients.Lab on a chip · 2025Article
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- Reduced Rate of Anemia after Transcatheter Aortic Valve Replacement.Journal of clinical medicine · 2024Article
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- Developments and Challenges in Durable Ventricular Assist Device Technology: A Comprehensive Review with a Focus on Advancements in China.Journal of cardiovascular development and disease · 2024Review
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- Cellular and Molecular Mechanisms Activated by a Left Ventricular Assist Device.International journal of molecular sciences · 2023Review
- Review
- Impact of the elevated angiopoietin-2 levels during Impella support on the short-term prognosis.Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs · 2023Article
- Predictive Model for Positive Video Capsule Endoscopy in Iron Deficiency Anemia.Digestive diseases and sciences · 2023Article
- Titanium is a potent inducer of contact activation: implications for intravascular devices.Journal of thrombosis and haemostasis : JTH · 2023Article
- Review
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9 authors at 1 institution in 1 country.
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Abstract
backgroundNonsurgical bleeding is the most common adverse event in patients with continuous-flow left ventricular assist devices (LVADs) and is caused by arteriovenous malformations. We hypothesized that deregulation of an angiogenic factor, angiopoietin-2 (Ang-2), in patients with LVADs leads to increased angiogenesis and higher nonsurgical bleeding.
methodsAng-2 and thrombin levels were measured by ELISA and Western blotting, respectively, in blood samples from 101 patients with heart failure, LVAD, or orthotopic heart transplantation. Ang-2 expression in endothelial biopsy was quantified by immunofluorescence. Angiogenesis was determined by in vitro tube formation from serum from each patient with or without Ang-2-blocking antibody. Ang-2 gene expression was measured by reverse transcription-polymerase chain reaction in endothelial cells incubated with plasma from each patient with or without the thrombin receptor blocker vorapaxar.
resultsCompared with patients with heart failure or those with orthotopic heart transplantation, serum levels and endothelial expression of Ang-2 were higher in LVAD patients (P=0.001 and P<0.001, respectively). This corresponded to an increased angiogenic potential of serum from patients with LVADs (P<0.001), which was normalized with Ang-2 blockade. Furthermore, plasma from LVAD patients contained higher amounts of thrombin (P=0.003), which was associated with activation of the contact coagulation system. Plasma from LVAD patients induced more Ang-2 gene expression in endothelial cells (P<0.001), which was reduced with thrombin receptor blockade (P=0.013). LVAD patients with Ang-2 levels above the mean (12.32 ng/mL) had more nonsurgical bleeding events compared with patients with Ang-2 levels below the mean (P=0.003).
conclusionsOur findings indicate that thrombin-induced Ang-2 expression in LVAD patients leads to increased angiogenesis in vitro and may be associated with higher nonsurgical bleeding events. Ang-2 therefore may contribute to arteriovenous malformation formation and subsequent bleeding in LVAD patients.
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