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Author Notes:

Correspondence to: W. H. Wilson Tang, MD, 9500 Euclid Avenue, Desk J3-4, Cleveland, OH 44195, Phone: (216) 444-2121, Fax: (216) 445-6165, Email: tangw@ccf.org

Dr. Butler reports research support from the NIH, and European Union; and is a consultant to Amgen, Bayer, Cardiocell, Celladon, Novartis, Ono Pharma, StealthPeptide, Takeda, Trevena, and Zensun.

Dr. Georgiopoulou reports research support from NIH. Dr. Kalogeropoulos reports research support from the NIH and AHA.


Research Funding:

This research was supported by grants from the National Institutes of Health and the Office of Dietary Supplements (R01HL103866, P20HL113452).

The GeneBank study was supported by NIH grants P01HL076491, P01HL098055, R01HL103931, and the Cleveland Clinic Clinical Research Unit of the Case Western Reserve University CTSA (UL1TR 000439-06).


  • Science & Technology
  • Life Sciences & Biomedicine
  • Cardiac & Cardiovascular Systems
  • Cardiovascular System & Cardiology
  • animal
  • heart failure
  • ligation
  • mice
  • placenta growth factor
  • VEGF

Elevated Soluble Fms-Like Tyrosine Kinase-1 and Placental-Like Growth Factor Levels Are Associated With Development and Mortality Risk in Heart Failure


Journal Title:

Circulation: Heart Failure


Volume 9, Number 1


, Pages e002115-e002115

Type of Work:

Article | Post-print: After Peer Review


Vascular endothelial dysfunction may play an important role in the progression of heart failure (HF). We hypothesize that elevated levels of vascular markers, placental-like growth factor, and soluble Fms-like tyrosine kinase-1 (sFlt-1) are associated with adverse outcomes in patients with HF. We also assessed possible triggers of sFlt-1 elevation in animal HF models. Methods and Results-We measured plasma placental-like growth factor and sFlt-1 in 791 HF patients undergoing elective coronary angiogram. Median (interquartile range) placental-like growth factor and sFlt-1 levels were 24 (20-29) and 382 (277-953) pg/mL, respectively. After 5 years of follow-up, and after using receiver operator characteristic curves to determine optimal cutoffs, high levels of sFlt-1 (≥280 pg/mL; adjusted hazard ratio, 1.47; 95% confidence interval, 1.03-2.09; P=0.035) but not placental-like growth factor (≥25 pg/mL; adjusted hazard ratio, 1.26; 95% confidence interval, 0.94-1.71, P=0.12) were associated with adverse cardiovascular outcomes. In addition, significant elevation of sFlt-1 levels was observed in left anterior descending artery ligation and transverse aortic constriction HF mouse models after 4 and 8 weeks of follow-up, suggesting vascular stress and ischemia as triggers for sFlt-1 elevation in HF. Conclusions-Circulating sFlt-1 is generated as a result of myocardial injury and subsequent HF development. Elevated levels of sFlt-1 are associated with adverse outcomes in stable patients with HF.

Copyright information:

© 2015 American Heart Association, Inc.

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