Angiographic methods to assess human coronary angiogenesis

It is unclear how agents designed to promote angiogenesis in the human hear t affect the arteriographic appearance of the collateral circulation. Possi ble changes in collateral vessels include new collateral vessels arising fr om epicardial arteries, new branches emanating from existing collateral ves sels, wider or longer collateral vessels, and higher dye transit rates that result in improved recipient vessel filling. Given the multiple mechanisms by which these new agents may improve myocardial perfusion, a rigorous, sy stematic, and comprehensive analysis of coronary arteriograms is required t o discern the true mechanism of benefit. The method of analysis must accoun t for potential changes in collateral blood flow, number, branching pat ter n, and length as well as changes in recipient vessel filling. The ability t o detect differences between intricate networks of vessels in an angiograph ic study is dependent on maintaining consistency in cinefilming as well as the core laboratory methods between time points. In this report, we describ e the methodology our angiographic core laboratory has found to be most eff ective to evaluate these very complex angiograms and attempt to capture all the possible modalities of angiogenesis.