title: Angiopoietin-2 in adults with congenital heart disease and heart failure.
abstract: BACKGROUND
  Chronic heart failure is an important cause for morbidity and mortality in adults with congenital heart disease (ACHD). While NT-proBNP is an established biomarker for heart failure of non-congenital origin, its application in ACHD has limitations. The angiogenic factors Angiopoietin-1 and -2 (Ang-1, Ang-2), vascular endothelial growth factor (VEGF), and soluble receptor tyrosine kinase of the Tie family (sTie2) correlate with disease severity in heart failure of non-congenital origin. Their role in ACHD has not been studied.
  
  
  METHODS
  In 91 patients Ang-2 and NT-proBNP were measured and related to New York Heart Association class, systemic ventricular function and parameters of cardiopulmonary exercise testing. Ang-1, VEGF, and sTie2 were also measured.
  
  
  RESULTS
  Ang-2 correlates with NYHA class and ventricular dysfunction comparable to NT-proBNP. Further, Ang-2 showed a good correlation with parameters of cardiopulmonary exercise testing. Both, Ang-2 and NT-proBNP identified patients with severely limited cardiopulmonary exercise capacity. Additionally, Ang-2 is elevated in patients with a single ventricle physiology in contrast to NT-proBNP. VEGF, Ang-1, and sTie2 were not correlated with any clinical parameter.
  
  
  CONCLUSIONS
  The performance of Ang-2 as a biomarker for heart failure in ACHD is comparable to NT-proBNP. Its significant elevation in patients with single ventricle physiology indicates potential in this patient group and warrants further studies.
authors.affiliation: Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Lukasz
authors.forename: Gernot
authors.initials: G
authors.lastname: Beutel
authors.forename: Philipp
authors.initials: P
authors.lastname: Kümpers
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Denecke
authors.forename: Mechthild
authors.initials: M
authors.lastname: Westhoff-Bleck
authors.forename: Bernhard
authors.initials: B
authors.lastname: Schieffer
authors.forename: Johann
authors.initials: J
authors.lastname: Bauersachs
authors.forename: Jan T
authors.initials: JT
authors.lastname: Kielstein
authors.forename: Oktay
authors.initials: O
authors.lastname: Tutarel
mesh_terms: D000328:Adult; D042683:Angiopoietin-1 / Q000097:blood; D042702:Angiopoietin-2 / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D015444:Exercise; D005260:Female; D006330:Heart Defects, Congenital / Q000097:blood* / Q000503:physiopathology; D006333:Heart Failure / Q000097:blood* / Q000503:physiopathology; D006334:Heart Function Tests; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D042787:Receptor, TIE-2 / Q000378:metabolism; D042461:Vascular Endothelial Growth Factor A / Q000097:blood
chemical_list: D042683:Angiopoietin-1; D042702:Angiopoietin-2; D015415:Biomarkers; D010446:Peptide Fragments; D042461:Vascular Endothelial Growth Factor A; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D042787:Receptor, TIE-2