The Value of Angiogenic Therapy with Intramyocardial Administration of Basic Fibroblast Growth Factor to Treat Severe Coronary Artery Disease
Yukihiro Katayama, MD, Kentaro Takaji, MD, Zhan-Qiang Shao, MD, PhD, Mai Matsukawa, MD, Ryuji Kunitomo, MD, PhD, Shoichiro Hagiwara, MD, PhD, Shuji Moriyama, MD, PhD, and Michio Kawasuji, MD, PhD
Background: Basic fibroblast growth factor (bFGF) was administered intramyocardially together with CABG to induce myocardial neovascularizaton and collateral growth in patients with ungraftable coronary arteries. Coronary angiographic and myocardial scintigraphic findings revealed that the effects of CABG were potentially confounding.
Methods and results: Patients in the bFGF group (n = 16) underw ent angiogenic therapy using bFGF for ungraftable territory, and incomplete revascularization (IR) patients (n = 22) underwent only CABG. The magnitude of collateral development was assessed by the Rentrop score and collateral connection (CC) grade. Rentrop scores tended to increase among patients in the bFGF group (before vs. after surgery, 1.9 ± 1.2 vs. 2.3 ± 1.2, p = 0.05), but not in the IR group. The CC grade significantly increased among patients in the bFGF group (before vs. after surgery, 1.0 ± 0.9 vs. 1.4 ± 0.5, p <0.05), but not in the IR group. Myocardial perfusion in territories injected with bFGF improved in 13 patients (81%) of the bFGF group, and also in the nonbypassed territory in 4 IR patients (25%) (p <0.05).
Conclusion: Angiogenic therapy with bFGF induced collateral development and improved myocardial perfusion in territories injected with bFGF. (Ann Thorac Cardiovasc Surg 2010; 16: 174-180)
Key words: angiogenic therapy, coronary artery disease, angiography, bFGF
Department of Cardiovascular Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
Received August 11, 2008; accepted for publication March 14, 2009
Address reprint requests to Yukihiro Katayama, MD: Department of Cardiovascular Surgery, Graduate School of Medical Sciences, Kumamoto University, Honjo 1–1–1, Kumamoto 860–8556, Japan.