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J Thorac Cardiovasc Surg 2004;127:535-540
© 2004 The American Association for Thoracic Surgery

Cardiopulmonary support and physiology

Adenoviral-mediated transfer of vascular endothelial growth factor 121 cDNA enhances myocardial perfusion and exercise performance in the nonischemic state

Paul Schalch, MDa, G. Farah Rahman, MDa, Gerald Patejunas, PhDa, Robert A. Goldschmidt, MDa, JoAnn Carbray, BSa, Mauricio A. Retuerto, BSa, David Kim, BSa, Karyn Esser, PhDd, Ronald G. Crystal, MDc, Todd K. Rosengart, MDa,b,*

a Evanston Northwestern Healthcare, Evanston, Ill, USA
b Northwestern University Medical School, Chicago, Ill, USA
c Weill Medical College of Cornell University, New York, NY, USA
d University of Illinois at Chicago, Chicago, Ill, USA

Received for publication December 9, 2002; revisions received April 21, 2003; accepted for publication June 5, 2003.

* Address for reprints: Todd K. Rosengart, MD, 2650 Ridge Ave, Burch 100, Evanston, IL 60201, USA
trosengart{at}enh.org

BACKGROUND: Angiogenic gene therapy has been demonstrated to enhance perfusion to ischemic tissues, but it is unknown whether the administration of angiogenic growth factors will increase blood flow to nonischemic tissues. This study investigates whether enhanced myocardial perfusion can be mediated by adenovirus-mediated transfer of vascular endothelial growth factor 121 cDNA to nonischemic myocardium.

METHODS: New Zealand White rabbits received adenovirus (5 x 1010 particle units) encoding for vascular endothelial growth factor 121 (n = 14) or a control vector without a transgene (n = 13) or saline solution (n = 9) via direct myocardial injection. Fluorescent microsphere perfusion studies and histologic analyses were performed 4 weeks later. In a parallel study, exercise treadmill testing was performed to assess the functional effects of this therapy in Sprague-Dawley rats.

RESULTS: Microsphere assessment of myocardial perfusion in rabbits 4 weeks after adenovirus-encoding vascular endothelial growth factor administration was greater than that for rats injected with control vector without a transgene or saline solution (3.2 ± 0.5 vs 2.7 ± 0.7 and 2.4 ± 0.4, respectively; P < .03). The endothelial cell count per high power field was increased in animals injected with adenovirus-encoding vascular endothelial growth factor versus animals injected with control vector without a transgene or saline solution (147 ± 27 vs 123 ± 14 and 125 ± 16 cells, respectively), although this did not reach statistical significance (P = .12). Rats treated with adenovirus-encoding vascular endothelial growth factor also demonstrated prolonged exercise tolerance compared with rats injected with control vector without a transgene or saline solution (exhaustion time: 26 ± 5 minutes vs 19 ± 2 minutes and 20 ± 3 minutes, respectively; P = .006).

CONCLUSIONS: Adenovirus encoding–mediated transfer of vascular endothelial growth factor 121 induces an enhancement in regional perfusion in nonischemic myocardium that corresponds to changes in exercise tolerance. Adenovirus-encoding vascular endothelial growth factor therapy may be useful for inducing angiogenesis in the nonischemic state, such as for prophylactic therapy of early coronary artery disease.




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