Angiogenesis and growth factor expression in a model of transmyocardial revascularization

Pelletier, Marc; Giaid, Adel; Sivaraman, Sujith; Dorfman, Julia; Li, Carlos M.; Philip, Anie; Chiu, Ray C.‐J.

doi:10.1016/s0003-4975(98)00388-9

Cited by 113 publications

(35 citation statements)

References 16 publications

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“…However, similar findings have been reported in canine models in which myocardial channels were not patent 2 months after treatment with TMLR 10,25,26 In animal models of acute infarction, TMLR-treated regions showed increased neovascularization around the channels. 9,10 However, these findings could be the result of the combined effect of ischemia and laser providing a powerful stimulus for angiogenesis in an otherwise healthy myocardium.…”

Section: Ii-136 Circulation November 9 1999mentioning

confidence: 99%

Measurement of Myocardial Blood Flow With Positron Emission Tomography Before and After Transmyocardial Laser Revascularization

Rimoldi¹,

Burns²,

Rosen³

et al. 1999

Circulation

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Background-Transmyocardial laser revascularization (TMLR) has been proposed for treatment of refractory angina. It has been hypothesized that transmural left ventricular channels created by laser improve myocardial blood flow (MBF) in the treated zones. We aimed to assess the effect of TMLR on MBF and coronary vasodilator reserve (CVR). Methods and Results-We measured MBF by means of PET with 15 O-labeled water in 7 patients with refractory angina, Canadian Cardiovascular Society (CCS) class 3.6Ϯ0.5, on 3 occasions: before and at 7.5Ϯ2.8 weeks (FU-1) and 34.6Ϯ4.7 weeks (FU-2) after TMLR performed with a synchronized, high-powered CO 2 laser. In each study, MBF was measured at rest and during maximal intravenous dobutamine. CVR was computed as dobutamine divided by resting MBF. After TMLR, CCS class was 2.2Ϯ1.7 at FU-1 and 2.4Ϯ1 at FU-2 (Pϭ0.04 versus pre-TMLR). Resting MBF in both lasered and nonlasered regions was unchanged after TMLR. Dobutamine MBF at baseline was 1.45Ϯ0.52 and 1.55Ϯ0.52 mL ⅐ min Ϫ1 ⅐ g Ϫ1 in lasered and nonlasered regions, respectively (PϭNS). At FU-1, dobutamine MBF in nonlasered regions had increased significantly to 1.89Ϯ0.82 mL ⅐ min Ϫ1 ⅐ g Ϫ1 (PϽ0.05) and was higher than in lasered regions (1.51Ϯ0.61 mL ⅐ min Ϫ1 ⅐ g Ϫ1 ; PϽ0.05 versus nonlasered). At FU-2, dobutamine MBF in nonlasered regions was still higher than in lasered regions (1.56Ϯ0.54 versus 1.21Ϯ0.44 mL ⅐ min Ϫ1 ⅐ g Ϫ1 ; PϽ0.01). CVR was comparable in nonlasered and lasered regions at baseline and FU-1, whereas it was higher in nonlasered regions at FU-2 (1.86Ϯ0.67 versus 1.53Ϯ0.72 mL ⅐ min Ϫ1 ⅐ g Ϫ1 ; PϽ0.05). Conclusions-TMLR has been shown to reduce angina in severely diseased patients. The results of our study do not support the hypothesis that the symptomatic benefit of TMLR can be ascribed to improved myocardial perfusion or CVR in lasered areas.

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Section: Ii-136 Circulation November 9 1999mentioning

confidence: 99%

Measurement of Myocardial Blood Flow With Positron Emission Tomography Before and After Transmyocardial Laser Revascularization

Rimoldi¹,

Burns²,

Rosen³

et al. 1999

Circulation

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“…But, histologically, these channels appear to be occluded shortly after TMR, thereby raising the question as to the molecular mechanism underlying therapy. Experimentally enhanced EPC-mediated vasculogenesis, enhanced perfusion and increased myocardial viability have been demonstrated following TMR (103)(104)(105)(106)(107)(108). In a porcine model of ischaemic cardiomyopathy, we have demonstrated an increase in microvascular perfusion following TMR (Figure 4) (104).…”

Section: Transmyocardial Laser Revascularizationmentioning

confidence: 93%

Untitled

2009

Robotics Computer Surgery

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Coronary artery disease is a global health concern, with increasing morbidity and mortality. Surgical coronary artery bypass grafting has been performed on cardiopulmonary bypass for nearly four decades, with excellent long-term durability. Beating-heart coronary surgery has been increasing in frequency in an attempt to decrease cardiopulmonary bypass-related morbidity. Furthermore, with increasing expertise and technology, minimally invasive and robotic techniques have been developed to enhance postoperative recovery, patient satisfaction and cosmesis. Several clinical trials have demonstrated decreased morbidity and more rapid recovery following off-pump, minimally invasive and robotic procedures when compared to on-pump coronary artery bypass grafts (CABGs). An equivalent extent of revascularization and medium-term anastomotic patency has been demonstrated among all approaches. Furthermore, for a large number of patients who do not have anatomy amenable to traditional coronary revascularization, adjunctive molecular therapies may provide alternative myocardial micro-revascularization.

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“…Numerous reports have demonstrated a histologic increase in neovascularization as a result of TMR channels [46, 48, 55, 56, 57, 58, 59, 60, 61]. More molecular evidence of this angiogenic phenomenon was derived from work that demonstrated an upregulation of vascular endothelial growth factor messenger RNA and expression of fibroblast growth factor 2 as well as matrix metalloproteinases following TMR [62, 63, 64]. Histologically, similar degrees of neovascularization have been noted after mechanical injury of various types.…”

Section: Mechanisms Of Tmrmentioning

confidence: 99%

Mechanisms and Results of Transmyocardial Laser Revascularization

Horvath

2004

Cardiology

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Transmyocardial laser revascularization (TMR) is a technique that has been performed on over 10,000 patients around the world. Most of the patients were not suffering from heart failure. TMR is principally used for the treatment of angina, but in patients with significant reversible ischemia that is not amenable to conventional therapy, TMR may also improve myocardial function. The results of using TMR as a treatment for angina show a dramatic improvement in symptoms and quality of life. This paper reviews the current status of TMR techniques, mechanisms and results.

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Angiogenesis and growth factor expression in a model of transmyocardial revascularization

Cited by 113 publications

References 16 publications

Measurement of Myocardial Blood Flow With Positron Emission Tomography Before and After Transmyocardial Laser Revascularization

Measurement of Myocardial Blood Flow With Positron Emission Tomography Before and After Transmyocardial Laser Revascularization

Untitled

Mechanisms and Results of Transmyocardial Laser Revascularization

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