Angiogenesis in ischemic human myocardium: Clinical results after 3 years

Background. Using the human fibroblast growth factor we could already demon strate the induction of neoangiogenesis in the ischemic human myocardium. Methods. Forty patients, who were undergoing elective coronary artery bypas s grafting were randomly selected and allotted either to a treatment or a c ontrol group. In 20 patients (study group) fibroblast growth factor was inj ected directly into the myocardium, close to the left anterior descending c oronary artery. The control group comprised 20 patients who had been inject ed with heat denatured fibroblast growth factor. The 3-year follow-up consi sted of a clinical examination, echocardiography, and selective imaging of the internal mammary artery bypass using angiography. Results. As with the early results, a dense new capillary network could be demonstrated angiographically in the region where the factor had been injec ted. Echocardiography showed an increase in the left ventricular ejection f raction in the study group. We also found a more pronounced improvement in the clinical appearance of the patients with fibroblast growth factor. Conclusions. Fibroblast growth factor, in addition to operative myocardial revascularization, may be the appropriate treatment for patients with perip heral stenosis or diffuse coronary arteriosclerosis. It is necessary to con firm these results in further studies on a larger group of patients. (C) 2000 by The Society of Thoracic Surgeons.