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Experimental Studies |
1 From the Departments of Radiology and Biomedical Imaging (M.S., A.M., L.D., M.B., C.B.H., D.S.) and Pathology (P.U.), University of California San Francisco, 513 Parnassus Ave, HSW 207B, San Francisco, CA 94134-0628. Received September 5, 2007; revision requested November 20; revision received January 11, 2008; accepted February 26; final version accepted March 13. Supported by a grant (R01HL7295) from the National Institutes of Health (M.S.) and a gift from ViroMed, Seoul, South Korea. Address correspondence to M.S. (e-mail: Maythem.Saeed{at}radiology.UCSF.edu).
Purpose: VM202, a newly constructed plasmid human hepatocyte growth factor, was transferred intramyocardially after infarction for the purpose of evaluating this strategy as a therapeutic approach for protection from left ventricular (LV) remodeling.
Materials and Methods: The institutional animal care and use committee approved this study. Pigs underwent coronary artery occlusion and reperfusion and served as either control (n = 8) or VM202-treated (n = 8) animals. VM202 was transferred intramyocardially into four infarcted and four periinfarcted sites. Cardiac magnetic resonance (MR) imaging (cine, perfusion, delayed enhancement) was performed in acute (3 days) and chronic (50 days ± 3 [standard error of the mean]) infarction. Histopathologic findings were used to characterize and quantify neovascularization. The t test was utilized to compare treated and control groups and to assess changes over time.
Results: In acute infarction, MR imaging estimates of function, perfusion, and viability showed no difference between the groups. In chronic infarction, however, VM202 increased maximum signal intensity and upslope at first-pass perfusion imaging and reduced infarct size at perfusion and delayed-enhancement imaging. These changes were associated with a decrease in end-diastolic (2.15 mL/kg ± 0.12 to 1.73 mL/kg ± 0.10, P < .01) and end-systolic (1.33 mL/kg ± 0.07 to 0.92 mL/kg ± 0.08, P < .001) volumes and an increase in ejection fraction (38.2% ± 1.3 to 47.0% ± 1.8, P < .001). In contrast, LV function deteriorated further in control animals. Compared with control animals, VM202-treated animals revealed peninsulas and/or islands of viable myocardium in infarcted and periinfarcted regions and greater number of capillaries (218 per square millimeter ± 19 vs 119 per square millimeter ± 17, P < .05) and arterioles (21 per square millimeter ± 4 vs 3 per square millimeter ± 1, P < .001).
Conclusion: Intramyocardial transfer of VM202 improved myocardial perfusion, viability, and LV function.
© RSNA, 2008
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