Bookmarkers beware: Bookmarks to pages other than the home page may not work after we change our server in April Editor's Choice | This Week in BMJ | Press releases BMJ No 7132 Volume 316 News Saturday 28 February 1998 Researchers grow new blood vessels in the heart Parents of babies who died or were left brain damaged after heart operations at Bristol Royal Infirmary held a candlelight vigil outside the General Medical Council last week, as James Wisheart, one of three doctors charged with serious professional misconduct, arrived to begin his evidence. They set out 50 shoeboxes painted black, each with a white cross, to represent tiny coffins. A banner proclaimed: "GMC: Great Massacre Cover-up." The parents are angry that the GMC investigation is focusing on only 53 operations of two types - arterial switch operations and open heart surgery to correct atrioventricular septal defects. Twenty nine of the 53 babies died, and four were left brain damaged. Surgery cannot correct multiple small vessel narrowing Photo: CNRI/SCIENCE PHOTO LIBRARY German doctors have grown new blood vessels in human hearts using genetically engineered human growth factor. This is a clinical first that could transform treatment for ischaemic heart disease. In a randomised controlled trial, researchers from the Fulda medical centre in Germany injected human growth factor FGF-I into the heart muscle of 20 patients undergoing bypass surgery for three vessel coronary artery disease (Circulation1998;97:645-50). All participants also had stenoses in peripheral branches that could not be treated with surgery, and the injection was targeted close to these sites. A control group received inactivated FGF-I in the same way. After only four days new capillary growth, radiating outward from the point of injection and bypassing stenoses, was clearly visible in an angiogram in all 20 patients. At 12 weeks, blood flow to the heart had increased by two to three times, and over the following three years the team found that the average ejection fraction improved from 50.3% to 63.8%. Controls showed an improvement of 7-8%. In addition, 10 of the 20 patients who received the growth factor now take no drugs except aspirin, and the remainder take substantially fewer and lower doses of cardiovascular drugs than controls. None have experienced any negative side effects. Research leader, Professor Thomas-Joseph Stegmann, said that angiogenesis offered a new therapeutic concept for diffuse coronary artery disease. "We can bypass the bigger vessels, but this does nothing for the additional lesions in the smaller vessels. For the first time we have been able to demonstrate that FGF-I can induce neoangiogenesis in situ in the ischaemic human heart. In our opinion this opens up new possibilities for treatment." Professor Stegmann said that it was not yet known whether growth factors could be effective enough to combat blockages of the larger arteries. His next focus is to find a way to deliver growth factor without surgery - for example, through a catheter. Professor Brian Pentecost, the medical director of the British Heart Foundation, said that the results were extremely encouraging. But researchers have yet to prove that the capillary vessels grown really make a functional difference, he noted. Hilary Bower London Home | Current issue | Past issues | Classified ads | Career Focus | Feedback Collections | About this site | About the BMJ | BMA | Medline