Biological and mechanical therapies enabled by cardiovas

在过去的一年里，我们继续我们的工作，应用快速核磁共振来指导简单和复杂的机械和生物干预。 我们正在开发临床级别的导管设备，以再通慢性周围动脉完全闭塞。这些设备应该可以在明年进行临床测试。其他导管设备也在开发中，用于动物的实时核磁共振程序。 我们正在开发基于导管的二尖瓣成形术来治疗功能性二尖瓣关闭不全。我们已经在二尖瓣反流的猪模型上取得了初步的成功。 临床前研究表明，动员的、附着性的、骨髓细胞移位到心肌中的研究在急性心肌梗死或慢性心肌缺血的小型和大型哺乳动物模型中没有好处。我们已经推迟了这些策略的进一步临床开发。 我们已经开发出了在临床前和临床导管操作过程中将先前MRI衍生的感兴趣区域与实时X射线相结合或融合的方法。例如，我们的X射线与核磁共振(XFM)系统融合在一起，便于在X射线透视下对心肌靶点进行精确注射。我们计划进一步开发这些技术，以促进广泛的部署。 临床研究即将开始完全使用实时核磁共振进行人类外周动脉介入，以及完全使用实时核磁共振对人类主动脉缩窄进行支架植入术。使用一种新的转录上调因子进行的治疗性血管生成的人类基因转移实验的临床登记仍在继续；该试验将测试安全性以及核磁共振对疗效的评估。

During the past year we have continued our work applying rapid MRI to guide simple and complex mechanical and biological interventions. We are developing clinical-grade catheter devices to recanalize chronic total occlusions of peripheral arteries. These should be ready for clinical testing next year. Other catheter devices also are under development for real-time MRI procedures in animals. We are developing catheter-based mitral annuloplasty to treat functional mitral valve regurgitation. We have had preliminary success in porcine models of mitral valve regurgitation. Preclinical studies of mobilized, apheresed, bone-marrow cell translocation into myocardium did not demonstrate benefit in small and large mammal models of acute myocardial infarction or chronic myocardial ischemia. We have deferred further clinical development of these strategies. We have developed methods to combine or "fuse" prior MRI-derived regions of interest with real-time X-ray during preclinical and clinical catheter-based procedures. For example, our X-ray Fused with MRI (XFM) system facilitated precise injections to myocardial targets under X-ray fluroscopy. We plan further development of these technologies to facilitate widespread deployment. Clinical studies are about to begin conducting human peripheral artery intervention wholly using real-time MRI, and stenting of aortic coarctation in humans wholly using real-time MRI. Clinical enrollment continues in a human gene transfer experiment for therapeutic angiogenesis using a novel transcriptional upregulator; the trial will test safety as well as MRI assessment of efficacy.