Association between vascular endothelial growth factor and atrial fibrillation: a systematic review.

Background: Atrial fibrillation (AF) is the most prevalent form of sustained cardiac arrhythmia, with vascular endothelial growth factor (VEGF) increasingly recognized for its potential role in the pathogenesis of AF through mechanisms involving atrial remodeling, inflammation, and fibrosis. This systematic review aims to synthesize available evidence on the association between VEGF and AF, exploring the implications of VEGF as a biomarker and therapeutic target.

Methods: We conducted a comprehensive search across PubMed, Embase, and Web of Science until November 10 2024, selecting studies based on pre-defined criteria that involve adults with AF and measurements of VEGF levels. The selected studies included observational and experimental designs, excluding non-English and methodologically insufficient publications. Narrative synthesis was used for summarising the results.

Results: Eight studies met the inclusion criteria. The studies show a general trend of elevated VEGF levels in AF patients compared to controls, with significant heterogeneity in findings across studies. VEGF subtypes such as VEGF-A and VEGF-D demonstrated stronger associations with AF risk compared to VEGF-C. These variations point to the complex role of VEGF in AF, influencing factors like angiogenesis, endothelial function, and inflammatory responses.

Conclusion: VEGF is potentially a significant contributor to AF pathophysiology, with its levels reflecting disease activity. The variability observed across studies suggests a need for standardized measurement approaches and further investigation into VEGF subtypes. Future research should focus on longitudinal studies to better understand the causal relationships and the potential of VEGF as a therapeutic target and biomarker in AF management.

Clinical trial number: Not applicable.