Document Detail


PET for evaluation of differential myocardial perfusion dynamics after VEGF gene therapy and laser therapy in end-stage coronary artery disease.
MedLine Citation:
PMID:  15347709     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The purpose of this study was to appraise the value of PET in the assessment of the effect of supposedly proangiogenic new therapies such as gene therapy with vascular endothelial growth factor (VEGF) gene and endomyocardial laser therapy. METHODS: Thirty-five patients with end-stage coronary artery disease and class III (Canadian Cardiovascular Society) angina were included. Myocardial ischemia was evaluated with dipyridamole PET scanning and exercise tolerance with bicycle ergometry. Ten patients were treated with naked plasmid DNA encoding for human VEGF165 (VEGF) and 12 patients were treated with laser therapy (direct myocardial revascularization [DMR]) using an electromechanical mapping system. Thirteen patients were treated with standard medical therapy (control). RESULTS: In both active treatment groups, angina was reduced in most subjects, except in 2 VEGF and 5 DMR patients. In the control group, no improvement in anginal classification was found, except in 3 subjects. On the PET scan, solely in the VEGF group, the stress perfusion was significantly improved (from 57 +/- 33 to 81 +/- 55 mL/min/100 g; P = 0.031). Furthermore, in the VEGF group, the number of ischemic segments was reduced from 274 +/- 41 to 234 +/- 48 segments (P = 0.004) but not in the DMR group (from 209 +/- 43 to 215 +/- 52 segments) or in the control group (from 218 +/- 18 to 213 +/- 28 segments). Bicycle exercise duration showed slight nonsignificant changes in the VEGF group (from 3.6 +/- 2.0 to 4.6 +/- 2.1 min), in the DMR group (from 5.1 +/- 1.5 to 4.7 +/- 1.3 min), and in the control group (from 3.3 +/- 1.8 to 3.5 +/- 2.3 min). CONCLUSION: PET showed that intramyocardial gene therapy with the human VEGF165 gene in contrast to laser DMR treatment effectively reduces myocardial ischemia.
Authors:
René A Tio; Eng S Tan; Gillian A J Jessurun; Nic Veeger; Pieter L Jager; Riemer H J A Slart; Richard M de Jong; Jan Pruim; Geke A P Hospers; Antoon T M Willemsen; Mike J L de Jongste; Ad J van Boven; Dirk J van Veldhuisen; Felix Zijlstra
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Validation Studies    
Journal Detail:
Title:  Journal of nuclear medicine : official publication, Society of Nuclear Medicine     Volume:  45     ISSN:  0161-5505     ISO Abbreviation:  J. Nucl. Med.     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-09-06     Completed Date:  2004-11-01     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0217410     Medline TA:  J Nucl Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1437-43     Citation Subset:  IM    
Affiliation:
Department of Cardiology, University Hospital Groningen, Groningen, The Netherlands. r.a.tio@thorax.az.ng
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MeSH Terms
Descriptor/Qualifier:
Coronary Artery Disease / classification,  genetics,  radionuclide imaging*,  therapy*
Coronary Vessels
Female
Gene Therapy / methods*
Humans
Laser Therapy / methods*
Male
Middle Aged
Myocardial Revascularization / methods*
Prognosis
Reproducibility of Results
Sensitivity and Specificity
Severity of Illness Index
Terminal Care / methods
Tomography, Emission-Computed / methods*
Treatment Outcome
Vascular Endothelial Growth Factor A / genetics*
Chemical
Reg. No./Substance:
0/Vascular Endothelial Growth Factor A

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


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