[New approaches to the treatment of ischemic heart disease: therapeutic angiogenesis in combination with surgical revascularization of the myocardium].
OBJECTIVE
To evaluate the results of surgical treatment of patients with ischemic heart disease in combination with intraoperative intramyocardial introduction of the human gene VEGF165 (angiostimulin).


METHODS
Twenty four patients enrolled in the study were examined using 12-lead ECG, echocardiography, treadmill exercise test, single-photon emission computed tomography of the myocardium with Tc-99m-tetrophosmine, fluorodesoxyglucose (FDG) positron-emission tomography of the myocardium, selective coronarography. Out of 24 patients, 10 patients have been reexamined so far. The effect of the treatment was assessed by the data obtained at the treadmill test, transthoracic echocardiography, myocardial scintigraphy and FDG.


RESULTS
All the patients demonstrated a clinical response. The class of effort angina improved, the dose of the prescribed nitric drugs was decreased, exercise tolerance and total stress time rose, quality of life improved. Myocardial scintigraphy registered reduction of the total area and better accumulation of the radiopharmaceutical under load and at rest 3 and 6 months after the operation including myocardial areas which had not been revacularised at coronary artery bypass grafting but had been treated with the preparation of the human gene VEGF165.


CONCLUSIONS
The results of the study suggest that therapeutic angiogenesis may be an alternative impact on those myocardial areas which are supplied by the affected but ineligible for bypass grafting coronary arteries.
Bokeriia
L A
LA
Golukhova
E Z
EZ
Eremeeva
M V
MV
Kiselev
S L
SL
Aslanidi
I P
IP
Vakhromeeva
M N
MN
Kliueva
A F
AF
Poliakova
E S
ES
Lukashkin
M A
MA
D003097:Collateral Circulation / Q000187:drug effects*; D003131:Combined Modality Therapy; D017023:Coronary Angiography; D004452:Echocardiography; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*; D009204:Myocardial Revascularization; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D011788:Quality of Life; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000008:administration & dosage / Q000627:therapeutic use*
D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D019788:Fluorodeoxyglucose F18; C078700:technetium tc-99m tetrofosmin