Document Detail

Induction of neoangiogenesis in ischemic myocardium by human growth factors: first clinical results of a new treatment of coronary heart disease.
MedLine Citation:
PMID:  9495299     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The present article is a report of our animal experiments and also of the first clinical results of a new treatment for coronary heart disease using the human growth factor FGF-I (basic fibroblast growth factor) to induce neoangiogenesis in the ischemic myocardium. METHODS AND RESULTS: FGF-I was obtained from strains of Escherichia coli by genetic engineering, then isolated and highly purified. Several series of animal experiments demonstrated the apathogenic action and neoangiogenic potency of this factor. After successful conclusion of the animal experiments, it was used clinically for the first time. FGF-I (0.01 mg/kg body weight) was injected close to the vessels after the completion of internal mammary artery (IMA)/left anterior descending coronary artery (LAD) anastomosis in 20 patients with three-vessel coronary disease. All the patients had additional peripheral stenoses of the LAD or one of its diagonal branches. Twelve weeks later, the IMA bypasses were selectively imaged by intra-arterial digital subtraction angiography and quantitatively evaluated. In all the animal experiments, the development of new vessels in the ischemic myocardium could be demonstrated angiographically. The formation of capillaries could also be demonstrated in humans and was found in all cases around the site of injection. A capillary network sprouting from the proximal part of the coronary artery could be shown to have bypassed the stenoses and rejoined the distal parts of the vessel. CONCLUSIONS: We believe that the use of FGF-I for myocardial revascularization is in principle a new concept and that it may be particularly suitable for patients with additional peripheral stenoses that cannot be revascularized surgically.
B Schumacher; P Pecher; B U von Specht; T Stegmann
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Circulation     Volume:  97     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1998 Feb 
Date Detail:
Created Date:  1998-03-17     Completed Date:  1998-03-17     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  645-50     Citation Subset:  AIM; IM    
Klinik für Thorax-, Herz und Gefässchirurgie, Klinikum Fulda, Germany.
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MeSH Terms
Capillaries / drug effects
Chick Embryo
Collateral Circulation / drug effects*
Combined Modality Therapy
Coronary Angiography
Coronary Circulation / drug effects*
Coronary Disease / drug therapy*,  physiopathology,  radiography,  surgery
Fibroblast Growth Factor 2 / pharmacology,  therapeutic use*
Internal Mammary-Coronary Artery Anastomosis
Middle Aged
Myocardial Revascularization / methods*
Neovascularization, Physiologic / drug effects*
Rats, Inbred Lew
Recombinant Fusion Proteins / pharmacology,  therapeutic use
Single-Blind Method
Stimulation, Chemical
Reg. No./Substance:
0/Recombinant Fusion Proteins; 103107-01-3/Fibroblast Growth Factor 2
Comment In:
Circulation. 1998 Feb 24;97(7):628-9   [PMID:  9495294 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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