Refractory angina is resistant to conventional therapies for coronary artery disease. Gene therapy to repair damaged heart muscle is most likely to succeed
if it can be injected at the site of ischemia where there is viable
myocardium with reduced contractile ability. A new technique that
combines imaging and electroanatomical mapping does just that.
of this novel approach that shows increased blood flow in treated areas
in patients with refractory angina is published in Human Gene Therapy
, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers.
‘Using a combination of electromechanical mapping and Positron Emission Tomography researchers have successfully directed intramyocardial gene therapy to the site of ischemia in the heart.’
Seppo Ylä-Herttuala, Kuopio University Hospital and University of
Eastern Finland (Kuo-pio, Finland), together with coauthors Antti
Kivelä, Antti Hedman, and Juha Hartikainen, and Antti Saraste and Juhani
Knuuti, from Turku University Hospital, Finland, describe their method
for targeted cardiac gene transfer in the article entitled "Intramyocardial
Gene Therapy Directed to Hibernating Heart Muscle Using a Combination
of Electromechanical Mapping and Positron Emission Tomography".
The researchers use a combination of electromechanical mapping with a
NOGA system and positron emission tomography (PET) radiowater perfusion
imaging to create two-dimensional bull's eye maps that guide the
injection of the gene therapy into the heart muscle. They target a site
that has suffered ischemic damage, but is viable as shown by reduced
contractile ability, to achieve the best possible outcome.
"Dr. Ylä-Herttualla's milestone clinical trial results demonstrate
how gene therapy for heart disease can be rendered much more specific,"
says Editor-in-Chief Terence R. Flotte, Celia and Isaac Haidak
Professor of Medical Education and Dean, Provost, and Executive Deputy
Chancellor, University of Massachusetts Medical School, Worcester.