Effects of endocardial bFGF administration using an electrode-equipped catheter in a porcine model of myocardial infarction

Introduction Basic fibroblast growth factor (bFGF) has long been recognized for its ability to promote angiogenesis in the treatment of cardiovascular diseases. In particular, it has been reported to play a role in myocardial repair mechanisms following myocardial infarction (MI). Both animal models and clinical studies suggest that bFGF administration may contribute to improved myocardial ischemia and preservation of left ventricular function. However, conventional direct myocardial injection through open-chest surgery is highly invasive, limiting its clinical application. Therefore, a more feasible and effective method for bFGF delivery needs to be considered. Purpose We have developed an electrode-equipped catheter that enables precise cell transplantation and drug administration based on real-time anatomical mapping using electroanatomical mapping (EAM). In this study, we evaluated the efficacy of bFGF administration using this catheter in a porcine model of MI, focusing on its potential to improve coronary microcirculation. Methods A porcine MI model was created by occluding the left anterior descending artery (LAD) with a balloon for 90 minutes. Three weeks post-MI, when microcirculatory dysfunction had stabilized, cardiac function was assessed, and coronary microcirculation parameters, including the index of microcirculatory resistance (IMR) and coronary flow reserve (CFR), were measured. Next, a voltage map was created using EAM to identify the infarcted area as a low-voltage region. BFGF was administered into the infarcted area through the endocardium using the developed electrode-equipped catheter (Figure 1). Real-time echocardiography was also used to confirm the intramyocardial injection. Two weeks after administration, cardiac function was reassessed, and IMR and CFR were remeasured. Results No complications, such as cardiac tamponade or fatal arrhythmias, were observed during the procedure. Left ventricular ejection fraction (LVEF) showed a trend toward improvement from 40.7±9.6% to 46.3±6.1%, although the difference was not statistically significant (P=0.17). On the other hand, IMR significantly improved from 29.50±8.43 to 15.00±1.41 (P=0.035), and CFR increased from 1.55±1.07 to 3.75±1.98 (P=0.027), suggesting an enhancement in coronary microcirculation. Conclusion Our study demonstrated that endocardial bFGF administration using the developed electrode-equipped catheter contributes to improving coronary microcirculation. This minimally invasive technique holds promise as a novel therapeutic option for patients post-MI.