Normalization of coronary microvascular reactivity and improvement in myocardial perfusion by surgical vascular endothelial growth factor therapy combined.

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Presentation transcript:

Normalization of coronary microvascular reactivity and improvement in myocardial perfusion by surgical vascular endothelial growth factor therapy combined with oral supplementation of l-arginine in a porcine model of endothelial dysfunction Pierre Voisine, MD, Cesario Bianchi, MD, PhD, Tanveer A. Khan, MD, Marc Ruel, MD, MPH, Shu-Hua Xu, PhD, Jun Feng, MD, PhD, Jian Li, MD, PhD, Tamer Malik, MD, Audrey Rosinberg, MD, Frank W. Sellke, MD The Journal of Thoracic and Cardiovascular Surgery Volume 129, Issue 6, Pages 1414-1420 (June 2005) DOI: 10.1016/j.jtcvs.2004.12.046 Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Microvascular reactivity studies: percentage relaxation to increasing concentrations of vasodilating agents after preconstriction with U46619. ADP, Endothelium-dependent vasodilator adenosine diphosphate; VEGF, partially endothelium-dependent vasodilator vascular endothelial growth factor; SNP, sodium nitroprusside, an endothelium-independent vasodilator. A, Normal diet group. B, High-cholesterol diet group. C, High-cholesterol diet with l-arginine supplementation. The Journal of Thoracic and Cardiovascular Surgery 2005 129, 1414-1420DOI: (10.1016/j.jtcvs.2004.12.046) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Top, Immunohistochemical staining for CD31 (CD31+) and corresponding negative control of an adjacent section (negative controls) in the left circumflex territory according to diet regimen 4 weeks after VEGF treatment. Bottom, Bar graph summarizing endothelial cell density results in the corresponding diet groups. *P < .05. The Journal of Thoracic and Cardiovascular Surgery 2005 129, 1414-1420DOI: (10.1016/j.jtcvs.2004.12.046) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Perfusion analyses. Post-VEGF versus pre-VEGF treatment ratios of circumflex (LCx) versus LAD blood flows in the different group treatments. The ratios are presented for both resting and stress conditions by ventricular pacing at 150 beats/min. Open column, Rest; filled column, pace. *P < .05. The Journal of Thoracic and Cardiovascular Surgery 2005 129, 1414-1420DOI: (10.1016/j.jtcvs.2004.12.046) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 A, Western blot analysis of VEGF, eNOS, and Akt protein levels in myocardial tissue harvested from the ischemic and nonischemic territories in all pigs 4 weeks after VEGF treatment. Ponceau S optical density was used as a correction factor for quantification. Relevant statistically significant differences in expression levels were highlighted, and P values are presented. Filled column, LAD; open column, left circumflex artery. *P < .05; **P < .01. The Journal of Thoracic and Cardiovascular Surgery 2005 129, 1414-1420DOI: (10.1016/j.jtcvs.2004.12.046) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions