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首页> 外文期刊>European journal of cardio-thoracic surgery: Official journal of the European Association for Cardio-thoracic Surgery >The combined use of transmyocardial laser revascularization (TMLR) and fibroblastic growth factor (FGF-2) enhances perfusion and regional contractility in chronically ischemic porcine hearts.
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The combined use of transmyocardial laser revascularization (TMLR) and fibroblastic growth factor (FGF-2) enhances perfusion and regional contractility in chronically ischemic porcine hearts.

机译：跨心肌激光血管重建术（TMLR）和成纤维细胞生长因子（FGF-2）的组合使用可增强慢性缺血性猪心脏的灌注和局部收缩性。

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OBJECTIVE: The purpose of this study was to determine the combined effect of transmyocardial laser revascularization (TMLR) and recombinant human basic fibroblastic growth factor (rhFGF-2) treatment in chronically ischemic hearts. METHODS: To employ this porcine ischemic model, an operative severe stenosis of the left anterior descending artery (LAD) was created (first operation). One week later, the animals were studied at baseline (second operation) by analyzing perfusion (microsphere technique) and regional contractility (ultrasonic crystals). Afterwards, pigs were randomized into one of the four groups: ischemic control group (n=7), TMLR-group (n=7), FGF-2-group receiving 500 &mgr;g rhFGF-2 (n=6), and FGF-2+TMLR-group receiving TMLR with 500 &mgr;g rhFGF-2 (n=6). Twelve weeks later, the animals were re-examined (third operation) and the hearts underwent additionally histochemical and immunohistologic analysis. RESULTS: Three months after therapy, regional myocardial blood flow (RMBF) in the LAD territory was significantly higher at rest in the FGF-2 group and FGF-2+TMLR group compared to baseline, control and TMLR group (FGF-2 group: 1.17+/-0.10 versus baseline 0.28+/-0.10, P=0.028; versus control 0.49+/-0.12, P=0.01; and versus TMLR 0.34+/-0.20, P=0.0081; FGF-2+TMLR group: 0.88+/-0.29 versus baseline 0.41+/-0.14, P=0.028; versus control 0.49+/-0.12, P=0.019 and versus TMLR group 0.34+/-0.20 ml/g per min, P=0.0032). Furthermore, the FGF-2+TMLR-group demonstrated higher RMBF values in the LAD territory under stress conditions compared to baseline (1.79+/-0.69 versus 0.41+/-0.14; P=0.028) and control (1.79+/-0.69 versus 0.78+/-0.55 ml/g per min; P=0.038) at the end of the study. In contrast to these groups, RMBF in the control and TMLR group was unchanged. After 3 months, the FGF-2- and FGF-2+TMLR-groups' regional contractility in the LAD territory revealed an improvement at rest (FGF-2: 84.00+/-26.22 versus baseline: 53.76+/-13.49, P=0.003; FGF-2+TMLR: 104.46+/-28.62 versus control: 61.27+/-5.13; P=0.005 and versus TMLR: 59.74+/-41.23%; P=0.041), whereas control and TMLR animals did not show any difference. TMLR as well as FGF-2+TMLR treatment resulted in an increased number of capillaries and of arterioles in the channel area compared to untreated ischemia (P<0.005). CONCLUSIONS: In contrast to the TMLR- and control group, CO(2)-laser revascularization combined with the application of intramyocardial growth factor, FGF-2, significantly ameliorates perfusion at rest and stress in this model of chronic regional ischemia, whereas sole FGF-2 application showed an improvement at rest only. This was mirrored by an enhancement of regional contractility in the FGF-2+TMLR- and FGF-2-group at rest.
机译：目的：本研究的目的是确定经心肌激光血管重建术（TMLR）与重组人碱性成纤维细胞生长因子（rhFGF-2）在慢性缺血性心脏中的联合治疗。方法：采用该猪缺血模型，建立了左前降支（LAD）的手术严重狭窄（首次手术）。一周后，通过分析灌注（微球技术）和局部收缩力（超声波晶体）在基线（第二次手术）研究了动物。之后，将猪随机分为四组之一：缺血对照组（n = 7），TMLR组（n = 7），接受500 mg g rhFGF-2（n = 6）的FGF-2-组和FGF-2 + TMLR-组接受500 mg rhFGF-2（n = 6）的TMLR。十二周后，再次检查动物（第三次手术），并另外对心脏进行组织化学和免疫组织学分析。结果：治疗三个月后，与基线，对照组和TMLR组（FGF-2组：）相比，FGF-2组和FGF-2 + TMLR组静息时LAD区域的局部心肌血流量（RMBF）显着更高。 1.17 +/- 0.10，相对于基线0.28 +/- 0.10，P = 0.028;相对于对照0.49 +/- 0.12，P = 0.01;相对于TMLR 0.34 +/- 0.20，P = 0.0081; FGF-2 + TMLR组：0.88 +/- 0.29 vs.基线0.41 +/- 0.14，P = 0.028;相对于对照0.49 +/- 0.12，P = 0.019，相对于TMLR组每分钟0.34 +/- 0.20 ml / g，P = 0.0032）。此外，FGF-2 + TMLR-组在压力条件下的LAD区域中的RMBF值高于基线（1.79 +/- 0.69对0.41 +/- 0.14; P = 0.028）和对照（1.79 +/- 0.69对在研究结束时为0.78 +/- 0.55 ml / g /分钟; P = 0.038）。与这些组相比，对照组和TMLR组的RMB保持不变。 3个月后，LAD区域中的FGF-2-和FGF-2 + TMLR组的区域收缩力显示出静息状态有所改善（FGF-2：84.00 +/- 26.22，而基线：53.76 +/- 13.49，P = 0.003; FGF-2 + TMLR：104.46 +/- 28.62 vs.对照：61.27 +/- 5.13; P = 0.005和vsTMLR：59.74 +/- 41.23％; P = 0.041），而对照和TMLR动物未显示任何区别。与未治疗的局部缺血相比，TMLR以及FGF-2 + TMLR治疗导致通道区域毛细血管和小动脉数量增加（P <0.005）。结论：与TMLR组和对照组相反，在这种慢性局部缺血模型中，CO（2）-激光血管再形成与心肌内生长因子FGF-2的应用显着改善了静息和压力下的灌注-2应用程序仅显示了静止状态的改进。静止时FGF-2 + TMLR-和FGF-2-基团的区域收缩性增强反映了这一点。

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