title: Therapeutic angiogenesis with recombinant fibroblast growth factor-2 improves stress and rest myocardial perfusion abnormalities in patients with severe symptomatic chronic coronary artery disease.
abstract: BACKGROUND
  We report the effects of the administration of recombinant fibroblast growth factor-2 (rFGF-2) protein on myocardial perfusion using single photon emission computed tomography imaging in humans with advanced coronary disease.
  
  
  RESULTS
  A total of 59 patients with coronary disease that was not amenable to mechanical revascularization underwent intracoronary (n=45) or intravenous (n=14) administration of rFGF-2 in ascending doses. Changes in perfusion were evaluated at baseline and again at 29, 57, and 180 days after rFGF-2 administration. In this uncontrolled study, perfusion scans were analyzed by 2 observers who were blinded to patient identity and test sequence; scans were displayed in random order, with scans from nonstudy patients randomly interspersed to enhance blinding. Combining all dose groups, a reduction occurred in the per-segment reversibility score (reflecting the magnitude of inducible ischemia) from 1.7+/-0.4 at baseline to 1.1+/-0.6 at day 29 (P:<0.001), 1.2+/-0.7 at day 57 (P:<0.001), and 1.1+/-0.7 at day 180 (P:<0.001). The 37 patients with evidence of resting hypoperfusion had evidence of improved resting perfusion: their per-segment rest perfusion score of 1.5+/-0. 5 at baseline decreased to 1.0+/-0.8 at day 29 (P:<0.001), 1.0+/-0.8 at day 57 (P:=0.003), and 1.1+/-0.9 at day 180 (P:=0.11).
  
  
  CONCLUSIONS
  These preliminary data suggest that the administration of rFGF-2 to patients with advanced coronary disease resulted in an attenuation of stress-induced ischemia and an improvement in resting myocardial perfusion; these findings are consistent with a favorable effect of therapeutic angiogenesis.
authors.affiliation: Cardiac Imaging Core Laboratory, Division of Cardiology, New England Medical Center Hospitals/Tufts University School of Medicine, Boston, MA 02111, USA. judelson@Lifespan.org
authors.forename: J E
authors.initials: JE
authors.lastname: Udelson
authors.forename: V
authors.initials: V
authors.lastname: Dilsizian
authors.forename: R J
authors.initials: RJ
authors.lastname: Laham
authors.forename: N
authors.initials: N
authors.lastname: Chronos
authors.forename: J
authors.initials: J
authors.lastname: Vansant
authors.forename: M
authors.initials: M
authors.lastname: Blais
authors.forename: J R
authors.initials: JR
authors.lastname: Galt
authors.forename: M
authors.initials: M
authors.lastname: Pike
authors.forename: C
authors.initials: C
authors.lastname: Yoshizawa
authors.forename: M
authors.initials: M
authors.lastname: Simons
mesh_terms: D003327:Coronary Disease / Q000188:drug therapy*; D016222:Fibroblast Growth Factor 2 / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D017202:Myocardial Ischemia / Q000188:drug therapy; D015425:Myocardial Reperfusion; D018919:Neovascularization, Physiologic / Q000187:drug effects*; D011994:Recombinant Proteins / Q000627:therapeutic use; D012146:Rest / Q000502:physiology; D013312:Stress, Physiological / Q000503:physiopathology; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods
chemical_list: D011994:Recombinant Proteins; D016222:Fibroblast Growth Factor 2