Basic fibroblast growth factor improves myocardial function in chronically ischemic porcine hearts.
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Key result
Basic fibroblast growth factor administration reduced left ventricular infarct size (1.2% vs 5.1%) and prevented pacing-induced hemodynamic deterioration in chronically ischemic porcine hearts.
Why the study?
Does extraluminal administration of bFGF improve myocardial function, blood flow, and reduce infarct size in a porcine model of chronic myocardial ischemia?
Population
28 Yorkshire pigs of either sex weighing 10-20 kg instrumented with proximal circumflex coronary artery…
Comparison
Basic fibroblast growth factor administered… vs Ameroid constrictor placed around the proximal…
Design
Preclinical
Follow-up
5-8 weeks
Authors
Discussion
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Implication
bFGF effects in porcine ischemia support human trials; extends preclinical RCT evidence for growth factor therapy in chronic CAD.
Structured PICO
Does extraluminal administration of bFGF improve myocardial function, blood flow, and reduce infarct size in a porcine model of chronic myocardial ischemia?
P
Population
26 Yorkshire pigs with ameroid constrictor-induced chronic myocardial ischemia, followed for 5-8 weeks.
I
Intervention
Basic fibroblast growth factor (bFGF) administered extraluminally to the proximal left anterior descending (LAD) and circumflex arteries via calcium alginate capsules encapsulating heparin-sepharose beads (total dose 4-5 µg/animal).
C
Comparator
Ameroid constrictor placed around the proximal circumflex artery without any heparin-alginate beads (n=7) or with heparin-alginate beads not containing bFGF (n=6).
O
Outcome
Left ventricular infarct size, regional myocardial blood flow, and regional myocardial function (percent fractional shortening) at rest and during rapid pacing.surrogate
Main Result
Absolute Event Rate: 1.2% vs 5.1%
p-value: p=<0.05
Periadventitial administration of bFGF in a porcine model of gradual coronary occlusion improves coronary flow, reduces infarct size, and prevents pacing-induced hemodynamic deterioration.
Limitations
- Potential delayed closure of ameroid constrictor in bFGF-treated animals due to local vasodilatory effects
- Possible baseline differences in the degree of preexisting collateral circulation between the two groups
- Optimal dose, length, or route of administration of bFGF remains unclear
- Does not address the effectiveness of bFGF in myocardium that is already ischemic, as seen in clinical settings
- Periadventitial administration requires open-chest surgery, whereas intracoronary delivery would be clinically preferable
Cite This Study
Harada et al. (1994) studied Chronic myocardial ischemia (n=26). Basic fibroblast growth factor (bFGF) vs. Control was evaluated on Left ventricular infarct size (% of LV mass) (p=<0.05). Basic fibroblast growth factor administration reduced left ventricular infarct size (1.2% vs 5.1%) and prevented pacing-induced hemodynamic deterioration in chronically ischemic porcine hearts.
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