Magnetic resonance mapping demonstrates benefits of VEGF–induced myocardial angiogenesis

Abstract

Coronary occlusive disease is the leading cause of death in industrial nations and affects one in four adults. Although heart attacks are caused by occlusion of a coronary artery, some patients have occlusions without infarction because they have sufficient collateral vessels providing an alternate pathway for blood supply. Vascular endothelial growth factor (VEGF) is an angiogenic peptide that can stimulate collateral vessel development in the ischaemic myocardium1–6. We used magnetic resonance imaging (MRI) and image processing to identify and quantify non–invasively the benefits related to VEGF infusion on collateral development in the heart. This was accomplished as a placebo–controlled study in the porcine model of chronic ischaemia7, 8 that most closely mimics the human pathophysiology of progressive coronary occlusion9. Image series converted to a space–time map demonstrated that with treatment the ischaemic zone was smaller and the contrast arrival delay was less, which resulted in better ejection fraction and regional wall thickening. These findings demonstrate in a manner applicable to humans, that VEGF improves collateral blood supply, resulting in improved cardiac global and regional function after and in spite of coronary artery occlusion. © 1995 Nature Publishing Group.