The stimulation of neoangiogenesis in the ischemic human heart by the growth factor FGF: first clinical results.
BACKGROUND
This paper is a report of our clinical experience with the human growth factor FGF as applied to the ischemic human myocardium.


METHODS
After the completion of extensive preliminary animal experiments, the growth factor FGF, obtained from genetically manipulated E. coli bacteria and highly purified, was introduced into aortocoronary bypass surgery as an additional therapeutic agent. A double blind study was carried out on 40 patients with CHD, separated into "growth factor" and control groups, each containing 20 members. All the patients were treated for threefold vascular disease, in each case with an IMA bypass for the LAD and single venous bypasses for the RCX and/or RCA. In order to bridge over additional peripheral stenoses in the LAD or one of its branches, human growth factor FGF was injected into the myocardium of those in the growth factor group. Twelve weeks later, the IMA bypasses were selectively demonstrated by intraarterial DSA. These angiographs were then quantitatively evaluated.


RESULTS
In all patients of the growth factor group, the formation of new vessels could be demonstrated in the region where FGF had been administered, in a manner strictly reminiscent of our experimental results. A capillary net sprouting from the coronary artery and making further connection with this vessel could be demonstrated, and the computer-supported evaluation of the angiographs showed a significant increase in the blood supply of the region of the myocardium injected.


CONCLUSIONS
It is therefore our opinion that employment of the human growth factor FGF represents a useful extension to bypass surgery, particularly for patients with an additional peripheral stenosis that cannot be operatively revascularized.
Schumacher
B
B
Department of Cardiac Surgery, University of Ulm, Germany.
Stegmann
T
T
Pecher
P
P
D015901:Angiography, Digital Subtraction; D000818:Animals; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003326:Coronary Circulation / Q000187:drug effects*; D004311:Double-Blind Method; D005346:Fibroblast Growth Factors / Q000008:administration & dosage / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D007432:Intraoperative Period; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery; D009206:Myocardium; D018919:Neovascularization, Physiologic / Q000187:drug effects*; D011817:Rabbits; D051381:Rats; D011994:Recombinant Proteins