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(Circulation. 2005;112:2108-2113.)
© 2005 American Heart Association, Inc.

Coronary Heart Disease

Vascular Endothelial Growth Factor Is Required for Coronary Collateral Growth in the Rat

Eiji Toyota, MD, PhD; David C. Warltier, MD, PhD; Tommy Brock, PhD; Erik Ritman, MD, PhD; Christopher Kolz; Peter O’Malley, BS; Petra Rocic, PhD; Marta Focardi, MD, PhD; William M. Chilian, PhD

From the Department of Physiology, Louisiana State University Health Sciences Center, New Orleans (E.T., C.K., P.O., P.R., M.F., W.M.C.); Department of Anesthesiology, Medical College of Wisconsin, Milwaukee (D.C.W.); Pharmacology and Preclinical Development, Texas Biotechnology Corporation, Houston (T.B.); and Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, Minn (E.R.).

Correspondence to William M. Chilian, PhD, Department of Physiology, Louisiana State University, Health Sciences Center, 1901 Perdido St, New Orleans, LA 70112. E-mail Chilian{at}LSUHSC.EDU

Received December 2, 2004; revision received June 29, 2005; accepted July 6, 2005.

Background— The goal of this study was to determine whether the expression of vascular endothelial growth factor (VEGF) is critical for coronary collateral growth. Previous studies have provided an association between coronary collateral growth and VEGF, but none have allowed determination of a causal role.

Methods and Results— We measured coronary collateral growth in rats subjected to repetitive episodes of myocardial ischemia (RI; one 40-second occlusion every 20 minutes for 2 hours 40 minutes, followed by 5 hours 20 minutes of rest, with this 8-hour cycle repeated 3 times per day for 10 days). Collateral growth was measured from blood flow (radioactive microspheres), visualization of arterial-arterial anastomoses (x-ray micro-CT), and maintenance of function during complete coronary occlusion in 3 groups of animals: sham (received instrumentation but no RI), experimental (subjected to RI), and anti–vascular endothelial growth factor (RI+anti-VEGF 0.6 mg/100 g per day) to block the endogenous actions of VEGF. In the 3 groups, native collateral flow (measurement for RI or sham protocol) averaged 0.2 to 0.3 mL · min^–1 · g^–1 of tissue. In the sham group, collateral flow did not increase during the protocol. Collateral flow in the control RI group increased by 6-fold to 1.63 mL · min^–1 · g^–1 tissue, but in the anti-VEGF group, collateral flow did not increase after the RI protocol (0.22 mL · min^–1 · g^–1). In acute experiments, collateral flow was unchanged during vasodilation with dipyridamole, indicating the increases in collateral flow are due to collateral growth and not vasodilation. X-ray micro-CT analysis revealed a 3-fold increase (versus sham group) in the number of arterial-arterial anastomoses per heart after RI, which was prevented by treatment with anti-VEGF. The growth of the collateral circulation was functional in the RI group because complete coronary occlusion did not induce any untoward effects on hemodynamics or arrhythmias. In the sham or anti-VEGF groups, coronary occlusion at the end of the protocol induced many arrhythmias and deterioration of function.

Conclusions— From these results, we conclude that the expression of VEGF is critical to the growth of coronary collaterals.

Key Words: angiogenesis • collateral circulation • coronary circulation • growth substances

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