Study On The Correlation Between Plasma Endocan Level And Coronary Collateral Circulation In Patients With Chronic Coronary Artery Occlusion

BackgroundCoronary atherosclerotic heart disease(CHD)has become an important disease that threatens human health.The most widely recognized pathological basis is coronary atherosclerosis and thrombosis based on unstable plaques leading to coronary artery Stenosis or even complete occlusion(Chronic total occlusion,CTO).Severe stenosis or complete occlusion of the coronary lumen can lead to the opening of coronary collateral circulation through mechanisms such as ischemia and hypoxia,and the formation of collateral circulation can reduce or avoid the necrosis of distal myocardium,which is of important clinical significance.Endocan,also known as endothelial specific molecule-1(Endocan),is a novel soluble endothelial cell-specific dermatan sulfate proteoglycan that plays a role in the pathophysiology of endothelial dysfunction disease It plays a key role as a new indicator of angiogenesis and reactivity to endothelial cells.It has been reported that Endocan can induce the endothelial cells to divide,proliferate,migrate and chemotaxis to form new blood vessels through the vascular endothelial growth factor(VEGF),another study found that VEGF can induce coronary artery formation,promote the formation of coronary collateral circulation.However,whether Endocan can promote the formation of coronary collateral circulation and its specific mechanism is not clear,needs further elucidation.ObjectiveThe purpose of this study was to determine the levels of Endocan and VEGF in patients with chronic coronary artery occlusion by enzyme-linked immunosorbent assay(ELISA),to explore the relationship between plasma levels and coronary collateral circulation,and Endocan's influence on coronary artery Collateral circulation formed by the predictive ability.MethodsA total of 107 patients undergoing coronary angiography(CAG)were hospitalized in Department of Cardiology,First Affiliated Hospital of Zhengzhou University from December 2016 to August 2017.Among them,Among them,CAG examination showed a total of 68 patients with CTO(three cardiologists involved in the blinded evaluation of coronary artery occlusions);According to the patients with coronary collateral circulation formation Rentrop score,among 35 patients with poor collateral circulation(Rentrop score 0/1),33 were better collateral circulation(Rentrop score 2/3).In the same period of hospitalization for CAG examination showed normal coronary artery or near normal(stenosis <30%)in 39 patients as a control group.Preoperative plasma samples were collected,the age and gender of blood lipids were collected and laboratory tests were performed.Endocan and VEGF levels were measured by ELISA.SSPS 21.0 software was used for data entry and analysis.T-test and logistic regression analysis were used to investigate the relationship between plasma Endocan and VEGF levels and the formation of coronary collateral circulation.Results1.Compared with the control group,Endocan and VEGF levels were significantly increased in patients with chronic coronary artery occlusion(3.22 ± 1.44 ng / ml vs 1.53 ± 0.68 ng / ml,P <0.01;126.68 ± 45.64 pg / ml vs 76.24 ± 37.45 pg / ml,P <0.01).The levels of Endocan and VEGF in plasma were positively correlated with coronary collateral circulation(r = 0.389,P <0.001).2.The levels of Endocan and VEGF were the lowest in Rentrop 0 group and the highest in Rentrop 3 group(1.64 ± 0.72 ng / ml vs 4.53 ± 0 ng / ml,P <0.01;75.91 ± 35.17 pg / ml vs 133.66 ± 0 pg / ml P <0.01).Endocan levels were statistically different between different Rentrop ratings(P <0.000).3.Pearson correlation analysis showed that in all cases of collateral circulation,there was a significant positive correlation between plasma Endocan level and VEGF level(r = 0.388,P <0.001).4.There was a significant positive correlation between plasma Endocan level and SYNTAX score(r = 0.552,P <0.01).This indicates that there is a strong correlation between the plasma Endocan level and the severity of coronary artery disease.The higher the level of plasma Endocan,the more serious the coronary artery disease is.5.In the ROC curve analysis,we found that 1.92 ng / ml Endocan levels were 69.7% sensitive and 68.6% specific to coronary artery collateral circulation;105.25 pg / ml VEGF was good for coronary collateral circulation A prediction of 69.7% sensitivity and 62.9% specificity.The area under the ROC curve corresponding to Endocan was 0.734;the area under the ROC curve corresponding to VEGF was 0.719.Therefore,plasma Endocan has a better predictive value for the formation of coronary collaterals than VEGF.Conclusion1.The level of plasma Endocan significantly increased in patients with better collateral circulation of chronic coronary artery occlusion;2.Endocan plasma levels at 1.92 ng / ml prompted the formation of coronary collateral circulation is good;3.Plasma Endocan levels are better predictors of coronary collaterals than VEGF.