title: HGF percutaneous endocardial injection induces cardiomyocyte proliferation and rescues cardiac function in pigs.
abstract: OBJECTIVE
  To investigate the effect of cardiomyocyte proliferation induced by human hepatocyte growth factor (HGF) in pigs with chronic myocardial infarction (CMI).
  
  
  METHODS
  A steerable, deflectable 7F catheter incorporating a 27-guage needle was advanced percutaneously to the left ventricular myocardium of 18 pigs with CMI. Pigs were randomized (1:1:1) to receive adenoviral vector HGF (total dose, 1×10(10) genome copies), which was administered as five injections into the infarcted myocardium (total, 1.0 mL), or saline, or Ad-null (control groups). Injections were guided by Ensite NavX left ventricular electroanatomical mapping. HGF and cyclin proteins were detected by western blot and immunoprecipitation analysis. Histological and immunohistochemical analysis determined proliferating cardiomyocytes. Myocardial perfusion and cardiac function were estimated by Gated-Single Photon Emission Computed Tomography (G-SPECT).
  
  
  RESULTS
  Western blot analyses showed that HGF were predominantly expressed in the infarct core and border in the myocardium of the infarcted heart. G-SPECT analysis indicated that the HGF group had better cardiac function and myocardial perfusion four weeks after the injection of Ad-HGF than before the injection of Ad-HGF. After treatment there were more proliferating cardiomyocytes in the HGF group compared to either of the control groups. Furthermore, the HGF group myocardial samples expressed higher levels of p-Akt, cyclin A, cyclin E, cyclin D1, cdk2, cdk4 than those in the control groups.
  
  
  CONCLUSIONS
  The over-expression of HGF activates pro-survival pathways, induces cardiomyocyte proliferation, and improves the perfusion and function of the porcine CMI heart.
authors.affiliation: Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China.
authors.forename: Zhengxian
authors.initials: Z
authors.lastname: Tao
authors.forename: Bo
authors.initials: B
authors.lastname: Chen
authors.forename: Yingming
authors.initials: Y
authors.lastname: Zhao
authors.forename: Hongwu
authors.initials: H
authors.lastname: Chen
authors.forename: Liansheng
authors.initials: L
authors.lastname: Wang
authors.forename: Yonghong
authors.initials: Y
authors.lastname: Yong
authors.forename: Kejiang
authors.initials: K
authors.lastname: Cao
authors.forename: Qifeng
authors.initials: Q
authors.lastname: Yu
authors.forename: Danian
authors.initials: D
authors.lastname: Ke
authors.forename: Hua
authors.initials: H
authors.lastname: Wang
authors.forename: Zuze
authors.initials: Z
authors.lastname: Wu
authors.forename: Zhijian
authors.initials: Z
authors.lastname: Yang
keywords: EnSite NavX; HGF; cardiac function; gene therapy; myocardial infarction; proliferation
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