Cardiovascular Journal of Africa: Vol 26 No 1 (January/February 2015)

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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 26, No 1, January/February 2015 AFRICA 21
Circulating adhesion molecules and arterial stiffness
Ismail Dogu Kilic, Gulin Findikoglu, Yusuf I Alihanoglu, Bekir Serhat Yildiz, Sukriye Uslu, Simin Rota,
Harun Evrengul
Abstract
Aim: VCAM-1 and ICAM-1 are two important members of
the immunoglobulin gene superfamily of adhesion molecules,
and their potential role as biomarkers of diagnosis, severity
and prognosis of cardiovascular disease has been investigated
in a number of clinical studies. The aim of the present study
was to determine the relationship between circulating ICAM-
1 and VCAM-1 levels and aortic stiffness in patients referred
for echocardiographic examination.
Methods: Aortic distensibility was determined by echocar-
diography using systolic and diastolic aortic diameters in 63
consecutive patients referred for echocardiography. Venous
samples were collected in the morning after a 12-hour over-
night fast, and serumconcentrations of ICAM-1 andVCAM-1
were measured using commercial enzyme immunoassay kits.
Results: Data of a total of 63 participants (mean age 55.6 ±
10.5 years, 31 male) were included in the study. Circulating
levels of adhesion molecules were VCAM-1: 12.604 ± 3.904
ng/ml and ICAM-1: 45.417 ± 31.429 ng/ml. We were unable
to demonstrate any correlation between indices of aortic stiff-
ness and VCAM-1 and ICAM-1 levels.
Conclusion: The role of soluble adhesion molecules in cardio-
vascular disease has not been fully established and clinical
studies show inconsistent results. Our results indicate that
levels of circulating adhesion molecules cannot be used as
markers of aortic stiffness in patients.
Keywords: VCAM-1, ICAM-1, adhesion molecules, aortic stiff-
ness
Submitted 14/7/14, accepted 18/9/14
Cardiovasc J Afr 2015; 26: 21–24
DOI: 10.5830/CVJA-2014-060
Damage to or stimulation of the endothelium leads
to the increased expression and release of molecules that
trigger leukocyte homing, adhesion and migration into the
subendothelial space, which are fundamental stages of the
development and progression of atherosclerosis.1 Among these,
adhesion molecules play a key role. Adhesion molecules are
substances that mediate the interaction between cells, their
extracellular matrices and endothelial surfaces. They function as
receptors that trigger intracellular pathways and participate in
the control of vital processes. 2
Once expressed on the endothelial surface, soluble forms of
adhesion molecules may be found in the circulation, released
either via shedding or proteolytic cleavage, and are considered
markers of increased expression of membrane-bound adhesion
molecules.3-5 Vascular cell adhesion molecule 1 (VCAM-1) and
intercellular adhesion molecule 1 (ICAM-1) are two important
members of the immunoglobulin gene superfamily of adhesion
molecules and their potential role as biomarkers of diagnosis,
severity and prognosis of cardiovascular disease has been
investigated in a number of clinical studies.6
Decreased arterial compliance is one of the earliest signs
of adverse structural and functional changes within the vessel
wall.7 Increased arterial stiffness represents a physiological
aspect of ageing, however, this process can be accelerated
by cardiovascular risk factors, and has been shown to be an
independent predictor of cardiovascular morbidity and all-cause
mortality in various populations.8-10
Although studies have also demonstrated that increased
arterial stiffness is associated with inflammation, data on the
association between aortic distensibility and soluble adhesion
molecules are sparse.11 The purpose of the present study was
to determine the relationship between circulating ICAM-1 and
VCAM-1 levels as inflammatory markers, and aortic stiffness in
patients referred for echocardiographic examination.
Methods
Sixty-three consecutive patients who were referred for
echocardiography were included in the study. Patients with renal
or hepatic failure, known infectious or inflammatory disease,
acute illness, moderate-to-severe valvular dysfunction, aortic
dissection or other aortic disease, or poor acoustic quality were
excluded. The study was approved by our local ethics committee,
and written informed consent was obtained from each participant.
Aortic stiffness measurements were performed on the subjects
in the left lateral decubitus position with echocardiography,
using a Vivid 7 Doppler echocardiographic unit (GE Vingmed
Ultrasound, Horten, Norway) with a 2.5-MHz probe. The aortic
diameter was recorded by M-mode echocardiography at a level
of 3 cm above the aortic valve.
Internal aortic diameters were measured by means of a caliper
in systole and diastole as the distance between the trailing edge
of the anterior aortic wall and the leading edge of the posterior
Department of Cardiology, Medical Faculty, Pamukkale
University, Denizli, Turkey
Ismail Dogu Kilic, MD,
Yusuf I Alihanoglu, MD
Bekir Serhat Yildiz, MD
Harun Evrengul, MD
Department of Physical Medicine and Rehabilitation,
Cardiopulmonary Unit, Medical Faculty, Pamukkale
University, Denizli, Turkey
Gulin Findikoglu, MD
Finike State Hospital, Antalya, Turkey
Sukriye Uslu, MD
Department of Biochemisty, Medical Faculty, Pamukkale
University, Denizli, Turkey
Simin Rota, MD