Intramyocardial protein therapy with vascular endothelial growth factor (VEGF-165) induces functional angiogenesis in rat senescent myocardium.

Myocardial capillary density and angiogenesis are impaired during aging but whether growth factor therapy is able to induce functional neovascularization in senescent heart have never been studied. In 3, 24, 28 and 32 mo male Wistar rats, cardiac hemodynamic measurements indicated heart failure at 28 and 32 mo, associated with left ventricular hypertrophy. VEGF/VEGF-R2, Ang-1/Ang-2/Tie-2 and PTN levels, quantitated in left ventricle by western blotting and immunohistochemistry, showed that VEGF and VEGF-R2 levels were specifically decreased during aging. In vitro angiogenesis ± rhVEGF-165 (5 and 50 ng/mL) was measured in aortic segments in 3D-collagen. Aortic sprouting was decreased during aging but restored by VEGF treatment (P<0.001), similarly in 3 and 24 mo with 50 ng/mLVEGF. Finally, 3 and 24 mo rats were submitted to in vivo intramyocardial rhVEGF-165 (10 micrograms) or saline solution injection and angiogenesis was measured by SPECT imaging of the alpha(v)beta(3) integrin-targeted tracer (99m)Tc-RAFT-RGD, capillary fluorescence staining in isolated perfused heart and vWF and alpha smooth muscle actin immunohistochemistry, 7 and 21 days later. VEGF administration increased capillary density in 3 but also in 24 mo rats at days 7 (+26%, P<0.01) and 21 (+41%, P<0.01) and arteriolar density at day 21 (+36%, P<0.01). Activity of (99m)Tc-RAFT-RGD and capillary fluorescence labeling indicated that new formed capillaries were functional. Cardiac aging was associated with strong VEGF/VEGF-R2 pathway downregulation. VEGF-165 protein therapy was able to induce in vitro and in vivo angiogenesis during aging. In 24 mo hearts, in vivo angiogenesis was functional, sustained and comparable to neovascularization observed in 3 mo hearts.

Pre-clinical and clinical evaluation of nuclear tracers for the molecular imaging of vulnerable atherosclerosis: an overview.

Cardiovascular diseases (CVD) are the leading cause of mortality worldwide. Despite major advances in the treatment of CVD, a high proportion of CVD victims die suddenly while being apparently healthy, the great majority of these accidents being due to the rupture or erosion of a vulnerable coronary atherosclerotic plaque. A non-invasive imaging methodology allowing the early detection of vulnerable atherosclerotic plaques in selected individuals prior to the occurrence of any symptom would therefore be of great public health benefit. Nuclear imaging could allow the identification of vulnerable patients by non-invasive in vivo scintigraphic imaging following administration of a radiolabeled tracer. The purpose of this review is to provide an overview of radiotracers that have been recently evaluated for the detection of vulnerable plaques together with the biological rationale that initiated their development. Radiotracers targeted at the inflammatory process seem particularly relevant and promising. Recently, macrophage targeting allowed the experimental in vivo detection of atherosclerosis using either SPECT or PET. A few tracers have also been evaluated clinically. Targeting of apoptosis and macrophage metabolism both allowed the imaging of vulnerable plaques in carotid vessels of patients. However, nuclear imaging of vulnerable plaques at the level of coronary arteries remains challenging, mostly because of their small size and their vicinity with unbound circulating tracer. The experimental and pilot clinical studies reviewed in the present paper represent a fundamental step prior to the evaluation of the efficacy of any selected tracer for the early, non-invasive detection of vulnerable patients.