The stimulation of neoangiogenesis in the ischemic human heart by the growth factor FGF: First clinical results

Background. This paper is a report of our clinical experience with the huma n growth factor FGF as applied to the ischemic human myocardium. Methods. After the completion of extensive preliminary animal experiments, the growth factor FGF, obtained from genetically manipulated E. coli bacter ia and highly purified, was introduced into aortocoronary bypass surgery as an additional therapeutic agent. A double blind study was carried out on 4 0 patients with CHD, separated into "growth factor" and control groups, eac h containing 20 members. All the patients were treated for threefold vascul ar disease, in each case with an IMA bypass for the LAD acid single venous bypasses for the RCX and/or RCA. In order to bridge over additional periphe ral stenoses in the LAD or one of its branches, human growth factor FGF was injected into the myocardium of those in the growth factor group. Twelve w eeks later, the IMA bypasses were selectively demonstrated by intraarterial DSA, These angiographs were then quantitatively evaluated. Results. In all patients of the growth factor group, the formation of new v essels could be demonstrated in the region where FGF had been administered, in a manner strictly reminiscent of our experimental results, A capillary net sprouting from the coronary artery and making further connection with t his vessel could be demonstrated, and the computer-supported evaluation of the angiographs showed a significant increase in the blood supply of the re gion of the myocardium injected. Conclusions. It is therefore our opinion that employment of the human growt h factor FGF represents a useful extension to bypass surgery, particularly for patients with an additional peripheral stenosis that cannot be operativ ely revascularized.