Catheter-based percutaneous transluminal gene delivery (PTGD) into the coro
nary artery still falls behind the expectations of an efficient myocardial
gene delivery system. In this study gene delivery was applied by selective
pressure-regulated retroinfusion through the coronary veins to prolong adhe
sion of replication defective adenovirus within the targeted myocardium. Ad
enoviral vectors consisted either of luciferase (Ad.rsv-Luc) or beta-galact
osidase (Ad.rsv-beta Gal) reporter gene under control of an unspecific prom
otor derived from the Rous sarcoma virus (RSV). In this pig model, selectiv
e retrograde gene delivery into the anterior cardiac vein during a brief pe
riod of ischemia substantially increased reporter gene expression in the ta
rgeted myocardium (LAD region) compared with antegrade delivery as a contro
l. Repeated retrograde delivery during two periods of brief ischemia result
ed in a more homogeneous transmural expression predominantly observed in ca
rdiomyocytes (X-gal-staining). In the nontargeted myocardium (CX region) th
ere was no evidence for adenoviral transfection. From our data we infer tha
t selective pressure-regulated retroinfusion is a promising approach for ef
ficient percutaneous transluminal gene delivery to the myocardium.