Yamamoto T, Suto N, Okubo T, Mikuniya A, Hanada H, Yagihashi S, Fujita M, Okumura K
Second Department of Internal Medicine, Hirosaki University School of Medicine, Japan.
Jpn Circ J. 2001 May;65(5):439-44. doi: 10.1253/jcj.65.439.
The present study examined whether basic fibroblast growth factor (bFGF)-impregnated acidic gelatin hydrogel microspheres (AGHM) would enhance collateral development to the infarct area in dogs with coronary occlusion. Studies were conducted in 28 dogs with a 2-week occlusion of the proximal left anterior descending coronary artery (LAD). The dogs were divided into 3 groups according to treatment: Group A treated with bFGF-impregnated AGHM in the infarct area; Group B with free-form bFGF; Group C with AGHM alone. Coronary angiography (n=15; Group A, 7 dogs; Group B, 5 dogs; Group C, 3 dogs) and a regional myocardial blood flow study (n=13; Group A, 6 dogs; Group B, 4 dogs; Group C, 3 dogs) were repeated at a 2-week interval. Coronary angiography revealed that in Group A, antegrade flow in the LAD distal to the occlusion, which was assessed by Thrombolysis in Myocardial Infarction (TIMI) grade, was significantly increased after treatment. In contrast, in Groups B and C, the treatment did not change the flow grade in the LAD. In Group A, the regional myocardial blood flow in the collateral dependent area was significantly increased after treatment, and the regional myocardial blood flow reserve after adenosine injection was also significantly increased. These measurements remained after treatment in Groups B and C. The immunohistochemical study with factor VIII-related antigen revealed an increase of vascular density in the ischemic region in Group A. Intramyocardial delivery of bFGF-impregnated AGHM, but not free-form bFGF, improves the collateral circulation to the infarct area of a coronary occlusion in dogs.
本研究检测了负载碱性成纤维细胞生长因子(bFGF)的酸性明胶水凝胶微球(AGHM)是否会增强冠状动脉闭塞犬梗死区域的侧支循环发育。对28只左前降支冠状动脉近端闭塞2周的犬进行了研究。根据治疗方法将犬分为3组:A组在梗死区域注射负载bFGF的AGHM;B组注射游离形式的bFGF;C组仅注射AGHM。每隔2周重复进行冠状动脉造影(n = 15;A组7只犬;B组5只犬;C组3只犬)和局部心肌血流研究(n = 13;A组6只犬;B组4只犬;C组3只犬)。冠状动脉造影显示,A组中,通过心肌梗死溶栓(TIMI)分级评估的闭塞远端左前降支的正向血流在治疗后显著增加。相比之下,B组和C组中,治疗并未改变左前降支的血流分级。A组中,治疗后侧支依赖区域的局部心肌血流显著增加,注射腺苷后的局部心肌血流储备也显著增加。B组和C组治疗后这些测量值保持不变。用VIII因子相关抗原进行的免疫组织化学研究显示,A组缺血区域的血管密度增加。心肌内注射负载bFGF的AGHM而非游离形式的bFGF,可改善冠状动脉闭塞犬梗死区域的侧支循环。