STIMULATION OF HUMAN CORONARY ANGIOGENESIS WITH BASIC FGF

点击翻译按钮获取中文摘要

The purpose of the present study is to the clinical efficacy of basic fibroblast growth factors (bFGF) in coronary angiogenesis in the setting of chronic myocardial ischemia. Ischemic coronary disease is the leading cause of morbidity and mortality in the Western world. Most available therapeutic approaches aim either at relieving symptoms by reducing myocardial oxygen demand, preventing further disease progression by modifying risk factors, restoring flow to a localized segment of the arterial tree (angioplasty) or bypassing obstruction (bypass surgery). However, no attempts have been made to restore blood supply to the myocardium by providing new venues for blood flow. Therapeutic angiogenesis may serve this goal. Angiogenesis is a complex process involving endothelial and smooth muscle cell proliferation and migration, formation of new capillaries, breakdown of existing extracellular matrix and formation of a new one. Relatively little is know regarding physiological importance and therapeutic potential of this process in chronic myocardial ischemia and molecular cellular events involved in its regulation are poorly understood. Preliminary investigation using animal models have shown that bFGF can be used to stimulate physiologically significant angiogenesis in myocardial ischemia. However, to date there has been no experience with the use of this growth factor in patients. The present study, therefore, will examine 3 Specific Aims: I. Angiogenic efficiency of bFGF chronic myocardial ischemia; II. Role of magnetic resonance imaging in noninvasive assessment of coronary angiogenesis; III. valuation of other tyrosine kinase ligands in stimulation of angiogenesis in chronic myocardial ischemia.