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Release: Oct. 7, 1999

UI cardiology specialist studies gene therapy to help heart grow new blood vessels

IOWA CITY, Iowa -- Cardiology specialists with University of Iowa Health Care have treated the first Iowan to receive a pioneering treatment for severe end-stage heart disease. The technique involves the use of gene therapy to help the heart sprout new blood vessels.

The treatment is part of an investigational protocol being conducted by John Lopez, M.D., UI assistant professor (clinical) of internal medicine, and Wayne Richenbacher, M.D., UI associate professor of surgery. The study continues their work in the area of myocardial angiogenesis, in which attempts are made to cause the heart to grow new blood vessels.

Previously, UI Health Care researchers studied a protein called Vascular Endothelial Growth Factor, or VEGF. The new study focuses on VEGF-2 gene therapy.

"This is truly cutting edge, very exciting research," said Lopez, a cardiologist. "The study is designed to determine if direct intramuscular gene therapy with VEGF DNA can cause sprouting, or growth of, new blood vessels to treat severe coronary artery disease."

The first Iowan to receive VEGF-2 gene therapy is William Hart, a social worker and counselor at Ottumwa Regional Health Center.

"I had coronary bypass graft surgery about 10 years ago after I had a heart attack," Hart said. "Now, I have blockages in my coronary arteries again but the arteries are too fragile for another bypass graft surgery or angioplasty."

"Attempts to revascularize the heart, such as using VEGF, are important for patients such as Mr. Hart," said Richenbacher, a cardiac surgeon. "He is certainly an example of someone who really does not have any other treatment options."

Richenbacher also uses another technique to improve blood flow in the heart, called transmyocardial revascularization, or TMR. TMR involves using a laser to drill tiny holes, or channels, in the heart to allow blood to reach areas of the heart that are not receiving optimal blood flow.

"Our experience with TMR and VEGF makes this one of the few centers in the world with ample experience in both of these new modalities for revascularization for patients with severe end-stage heart disease," Lopez said. "This is an important new service for people who are often told that nothing can be done for them."

Patients with severe coronary artery disease often experience chest pain, shortness of breath and fatigue.

"My life and lifestyle were both becoming very limited. I couldn't even climb a set of stairs," Hart said. "I hope that this will help me lead a normal life again."

The research team will monitor Hart's condition closely and perform scans to determine if his heart does indeed sprout new blood vessels. The study is being conducted in five medical centers in the United States. The VEGF-2 gene therapy study is being directed by Cato Research and Vascular Genetics. It is an open label, Phase II study, and it follows preliminary research done by Jeff Isner, M.D., chief of cardiovascular research at St. Elizabeth's Medical Center in Boston.

(NOTE TO EDITORS: A videotaped interview with William Hart is available. For more information, contact Tom Moore at (319) 356-3945.)

University of Iowa Health Care describes the partnership between the UI College of Medicine and the UI Hospitals and Clinics and the patient care, medical education and research programs and services they provide.