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Catheter-based myocardial gene transfer utilizing nonfluoroscopic electromechanical left ventricular mapping
P R Vale1, D W Losordo, T Tkebuchava
1Division of Cardiovascular Research, St. Elizabeth's Medical Center, and Tufts University School of Medicine, Boston, Massachusetts, USA.
Journal of the American College of Cardiology
|July 10, 1999
Summary
This study demonstrates that percutaneous, catheter-based myocardial gene transfer is feasible and safe in pigs. This minimally invasive approach shows potential for cardiovascular gene therapy without significant complications.
Area of Science:
- Cardiovascular Research
- Gene Therapy
- Minimally Invasive Procedures
Background:
- Traditional myocardial gene transfer requires open-chest surgery (thoracotomy).
- A less invasive method for delivering genes directly to the heart muscle is needed.
Purpose of the Study:
- To investigate the feasibility and safety of percutaneous, catheter-based myocardial gene transfer.
- To establish a minimally invasive approach for cardiovascular gene delivery.
Main Methods:
- Utilized electroanatomical mapping to identify left ventricular (LV) targets.
- Employed a steerable catheter with a needle for LV myocardial injections.
- Delivered plasmid DNA (pCMV-nlsLacZ) to normal and ischemic myocardium in pigs.
Main Results:
- Successful gene transfer was confirmed by methylene blue staining and beta-galactosidase activity.
- Peak gene expression was observed at the targeted LV injection sites.
- All animal subjects survived the procedures without observed complications.
Conclusions:
- Percutaneous myocardial gene transfer is achievable in both normal and ischemic conditions.
- This technique offers a safe and effective alternative to open-chest surgery.
- The findings support the potential of minimally invasive cardiovascular gene transfer.
