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  • 1
    Digitale Medien
    Digitale Medien
    350 Main Street , Malden , MA 02148-5020 , USA , and P.O. Box 1354, Garsington Road , Oxford OX4 2DQ , UK . : Blackwell Science Inc
    Journal of interventional cardiology 18 (2005), S. 0 
    ISSN: 1540-8183
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: Background: The short-term clinical impact of intramyocardial gene transfer (GT) of the angiogenic protein vascular endothelial growth factor-2 (VEGF-2) has been previously reported to significantly reduce Canadian Cardiovascular Society (CCS) angina class and to prolong exercise treadmill test (ETT) time. We describe the safety and long-term events (〉1 year) in consecutive, nonrandomized, patients who received intramyocardial VEGF-2. Methods: Thirty patients with intractable CCS class III or IV angina and no options for revascularization underwent direct intramyocardial GT of VEGF-2 naked DNA via limited thoracotomy at total doses of 0.2, 0.8, or 2.0 mg. Patients were followed for clinical events after 1 year by hospital records, follow-up visits or telephone contact. Due to one perioperative death, 29 patients were followed. Results: At a mean follow-up of 751 ± 102.5 days (range 459–959) there were four deaths (13.8%), five myocardial infarctions (MIs) (17.2%), and seven revascularization procedures (24.1%). There were 15 hospitalizations in 12 patients. At the end of the follow-up period no patient (0%) had CCS class IV angina, 3 patients (11.5%) had class III angina, and 23 (88.5%) had class I to II angina. There were two new diagnoses of cancer. Conclusion: Transthoracic intramyocardial injection of VEGF-2 is associated with an improvement of symptoms of angina in the majority of patients beyond the first year of treatment. Major clinical events such as death, MI, and repeat revascularization are uncommon during the first year but more frequent after 1 year at a rate consistent with the severity of underlying disease in this population with advanced atherosclerosis. The majority of events were the result of progression of disease in areas of the heart remote from the site of GT. A large randomized trial is planned to determine the efficacy of intramyocardial VEGF-2 injections in inoperable patients.
    Materialart: Digitale Medien
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  • 2
    Digitale Medien
    Digitale Medien
    Oxford, UK : Blackwell Publishing Ltd
    Clinical and experimental pharmacology and physiology 23 (1996), S. 0 
    ISSN: 1440-1681
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: 1. Animal and human studies indicate that female sex hormones are protective against the development of coronary atherosclerosis.2. Experiments on vascular smooth muscle cells suggest a direct effect of oestrogen on vascular tissue. Although oestrogen receptors (ER) in vascular tissues and an association between ER stimulation and physiological effects have been demonstrated, the cellular mechanisms underlying the effects of oestrogen on the arterial wall remain to be defined.3. Elucidation of the cellular mechanism underlying the effects of oestrogen on vascular smooth muscle will provide insights into coronary atherosclerosis and will provide an opportunity to apply the protective effects of oestrogen to women in older age groups and to the male population.
    Materialart: Digitale Medien
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  • 3
    Digitale Medien
    Digitale Medien
    [s.l.] : Nature America Inc.
    Nature medicine 5 (1999), S. 491-492 
    ISSN: 1546-170X
    Quelle: Nature Archives 1869 - 2009
    Thema: Biologie , Medizin
    Notizen: [Auszug] A new study answers one set of questions, but raises many more, about the potential use of specific VEGF isoforms to promote re-vascularization for ischemic cardiomyopathy (pages ...
    Materialart: Digitale Medien
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  • 4
    ISSN: 1573-742X
    Schlagwort(e): unstable angina ; atherectomy ; thrombus
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Background: The transient and generally nonfatal nature of unstable angina has impaired the accumulation of pathologic data and the definition of the pathoanatomy of this syndrome.Methods: Atherectomy specimens from patients enrolled in CAVEAT were examined for the presence of thrombus, foam cells, cholesterol clefts, media, and adventitia. Comparison of the pathologic findings was made according to clinical presentation in the following categories: stable angina, unstable angina, and recent myocardial infarction.Results: Patients with unstable angina had a slightly higher incidence of thrombus when compared with patients presenting with stable angina (36% vs. 26%, p = .14). Within the unstable angina population some subgroups demonstrated a greater incidence of thrombus, including those whose pain was associated with ECG changes (43%, p =.06) or occurred after myocardial infarction (42%, p = .07). The incidence of thrombus was highest among patients who had a myocardial infarction within 30 days (53%, p =.004) or within 14 days (58%, p=.003). No difference between the patient groups was detected with respect to the other histologie findings.Conclusions: Atherectomy specimens from patients with unstable angina demonstrated a trend toward increasing incidence of thrombus, but this trend did not achieve statistical significance. Specimens from patients with a recent myocardial infarction did not demonstrate a significant increase in the presence of thrombus. While thrombus is a component of the pathophysiology of unstable angina in a significant number of patients, continued study is required to determine the other factors that are responsible.
    Materialart: Digitale Medien
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  • 5
    Digitale Medien
    Digitale Medien
    Springer
    Journal of thrombosis and thrombolysis 1 (1995), S. 299-302 
    ISSN: 1573-742X
    Schlagwort(e): vascular smooth muscle cell ; atherosclerosis ; gene transfer ; liposomes
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary Complexing recombinant DNA with cationic liposomes is a convenient means of introducing foreign genes into cells (lipofection) and could potentially form the basis for genetically modifying diseased blood vessels in patients. The mechanism of lipofection is incompletely understood, but it is recognized that the degree of successful gene transfer is highly dependent on cell type. We have transfected primary cultures of human vascular smooth muscle cells with a plasmid expressing either firefly luciferase (Luc) or nuclearlocalized β-galactosidase (NL-β-gal). Cells were derived from either normal human internal mammary arteries, fragments of primary atherosclerotic plaque, or fragments of restenotic lesion. Concurrent lipofection of rabbit vascular smooth muscle cells and NIH 3T3 cells was performed as well. Compared with NIH 3T3 cells, expression in human vascular smooth muscle cells was markedly reduced: In cells derived from internal mammary artery, Luc expression, normalized for protein content, was 123-fold lower than in NIH 3T3 cells, while the proportion of cells expressing NL-β-gal was 30-fold lower. Luc expression in cells derived from restenotic tissue was significantly greater than from cells derived from primary plaque. Within a given population of cells, the mitotic index of cells expressing the recombinant gene was significantly higher than the mitotic index for the total population of cells (p 〈 0.05). Finally, cotransfection experiments, in which lipofection of smooth muscle cells was performed using genes for NL-β-gal and for human growth hormone, showed that among positive transfectants a high proportion of cells (23–36%) coexpressed both genes. Thus, the efficiency of successful lipofection in human vascular smooth muscle cells in vitro is low. Transfection appears to be preferentially facilitated in cells derived from restenotic tissue and specific properties of smooth muscle cells, including growth rates, appear to be critical for successful transfection. Further elucidation of cell properties that promote transfection is required to augment the efficiency of liposome-mediated gene transfer in human vascular cells.
    Materialart: Digitale Medien
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  • 6
    Digitale Medien
    Digitale Medien
    Springer
    Journal of thrombosis and thrombolysis 3 (1996), S. 71-86 
    ISSN: 1573-742X
    Schlagwort(e): remodeling ; restenosis
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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