Can HIF-1 alpha (Hypoxia- inducible factor-1 alpha) be a new cardiac hypoxia marker in acute coronary ischemia?
HIF-1 alfa (Hypoxia- inducible factor-1 alpha) akut koroner iskemide yeni bir kardiyak hipoksi belirteci olabilir mi?
Objective: Hypoxia- inducible factor-1 alpha (HIF-1 alpha) is a gene protein whose activation is a primary defensive mechanism against tissue hypoxia. It is the main regulator of cellular oxygen delivery and consumption. HIF-1 alpha activity is increased in tissue ischemia and this induces the angiogenic growth factor release that is needed for vascular remodelling and collateral formation, and contributes to improvement in cardiac functions .
In this study, it was aimed to measure HIF-1 alpha levels in acute cardiac ischemia , evaluate its relationship with inflammatory and biochemical parameters and investigate HIF-1 alpha as a possible cardiac hypoxia marker.
Material and methods: First 35 patients who were admitted to coronary intensive care unit (ICU) with ACS diagnosis in March 2018 and 22 age-gender-matched healthy control group were included in the study. 4 patients from case group were excluded due to malignancy history. In both case (coronary ICU patients) and control groups, after 12-hours of hunger, venous blood samples were taken to measure HIF-1 alpha, biochemical parameters (glucose, urea, creatinine, uric acid, AST; ALT, GGT), haemoglobin, platelets, platelet parameters (MPV, PCT, PDW), inflammatory parameters (CRP, Neutrophil/Lymphocyte ratio) and homosistein levels. Results were evaluated using SPSS 22.0 program.
Results: 31 case and 22 control group, totally 53 patients were included in the study. The mean age was 68.2± 14.3 years in case group and 63.6±9.6 years in control group. Age and gender distribution, glucose, AST, ALT, PLT, MPV, PCT, PDW and homosistein levels did not show any significant difference in case and control groups (p > 0.05). Urea, creatinine, uric acid, GGT, CRP, Hb, N/L levels were significantly higher in case group when compared to control group (p ˂ 0.05). Although HIF-1 alpha level was higher in case group when compared to control group, it was not statistically significant.
Conclusion: There are studies showing the role of HIF-1 alpha in cardiac function improvement via increased tissue oxygenation but same adaptive mechanism was not observed in our study. The presence of only localized ischemia, immediate application of medical treatment and lack of anemia or hypertension could be the explanatory factors for this difference. New treatment modalities to protect the heart from ischemic damage will be available when our knowledge about cardiac functions at different oxygen levels and factors effecting them, increases. Then, HIF-1 alpha might be re-evaluated as a potential cardiac hypoxia marker.
Keywords: HIF-1 alpha,hypoxia,coronary ischemia
Key words: HIF-1 alpha,hypoxia,coronary ischemia
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