Therapeutic angiogenesis with recombinant fibroblast growth factor-2 improves stress and rest myocardial perfusion abnormalities in patients with severe symptomatic chronic coronary artery disease.
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.
Udelson
J E
JE
Cardiac Imaging Core Laboratory, Division of Cardiology, New England Medical Center Hospitals/Tufts University School of Medicine, Boston, MA 02111, USA. judelson@Lifespan.org
Dilsizian
V
V
Laham
R J
RJ
Chronos
N
N
Vansant
J
J
Blais
M
M
Galt
J R
JR
Pike
M
M
Yoshizawa
C
C
Simons
M
M
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
D011994:Recombinant Proteins; D016222:Fibroblast Growth Factor 2