Angiogenesis Research/The OPTIMIST Program
The OPTIMIST Program at the Minneapolis Heart Institute was created as a systematic way to screen coronary artery disease patients whose angina is not controlled with medications and who cannot have coronary artery bypass or angioplasty. Patients meet with our nurses and doctors and together they decide the best treatment or research option. These options may include coronary angiogenesis research, spinal cord stimulation research, Enhanced External Counterpulsation therapy, new medications or combination therapies, i.e., surgery plus angiogenesis, surgery plus Transmyocardial Laser Revascularization.
Coronary Angiogenesis Research
Angiogenesis research is the study of growth hormones used to increase the blood supply to areas in need of more blood. Two of these growth hormones (proteins), Fibroblast Growth Factor (FGF) and Vascular Endothelial Growth Factor (VEGF) have been studied in Phase I and Phase II trials. They are naturally produced in the human body to start the growth of tiny arteries, called collateral vessels, in areas where blood flow is limited. For example, when the arteries that deliver blood to your heart muscle, called coronary arteries, are narrowed or blocked, your body will secrete FGF and VEGF to grow new collateral vessels. These new arteries will deliver blood flow to the areas that are not getting enough blood. However, collateral vessels are much smaller than the major arteries in your heart and deliver smaller amounts of blood flow to the heart muscle. Sometimes patients do not grow enough collateral vessels to prevent angina (chest pain) from occurring. Angina occurs because of a decreased supply of blood to the heart. This is where angiogenesis research may help. By giving more of what your body produces naturally, that is, growth hormones specially designed to create blood vessels, such as VEGF and FGF (or the gene that turns them on in the case of HIF-1?), new blood vessels may be grown which will improve the blood supply to the heart and decrease angina. Choose the following link for more on gene therapy.
EECP
Enhanced External Counterpulsation, or EECP, is a FDA approved therapy for the treatment of angina in patients who cannot have coronary artery bypass surgery or angioplasty. EECP is a non-invasive treatment that has been proven to decrease or even eliminate angina (chest pain). Angina happens when the heart does not get enough oxygen, possibly because of a narrowed or blocked artery reducing the amount of blood going to the heart muscle. EECP works by stimulating the creation or opening of tiny new blood vessels to increase the amount of blood going to the heart muscle with each heart beat.
Neurostimulation
Spinal Cord Stimulation (SCS) is a treatment for angina that is widely used in Europe. It is being studied now in the United States. A device (like a TENS unit) is surgically implanted and works by delivering mild electrical signals to the area of the spinal cord that corresponds to the location of a patient’s angina. These electrical signals may ease the sensation of angina by interfering with the transmission of angina pain signals.
New Drugs
In our quest to improve the quality of life for our patients, new drugs for the treatment of angina are studied. Most recently, we have studied Ranolazine and LArginine.
Transmyocardial Laser Revascularization (TMR)
Transmyocardial laser revascularization involves using a laser probe to create channels through the myocardium (heart muscle). This relatively new procedure has been in research development since the 1960s in animal models and now holds promise for persons with severe symptomatic coronary disease. TMR may be used along with coronary artery bypass graft surgery or other cardiac surgical procedures. Typically between 15 to 50 channels are created during the procedure. It is important to realize that TMR results in a gradual improvement in circulation to the heart muscle; therefore, benefits may not be immediate, but come in the months following surgery.
Current Research Studies:
Research Studies that are closed to new patients/follow-up only:
Click here to view a list of Archived Angiogenesis Research/The OPTIMIST Program
Charlene Boisjolie, RN, MA
Frazier Eales, MD
Thomas F. Flavin, MD
Linda Flies Carole, PsyD, LP
Timothy D. Henry, MD, FACC
Randall K. Johnson, MD, FACC
Timothy J. Kroshus, MD, PhD
Vib R. Kshettry, MD
John R. Lesser, MD, FACC
Anil K. Poulose, MD, FACC
Jay H. Traverse, MD, FACC, FAHA
Terri Arndt, RN, MA, CCRC
Karen L. Harvey, RN
Patti Mitchell, RN, BSN
Rachel Olson, RN, MS, CCRC
Dodie Walton, RN, CCRC
For more information about the OPTIMIST Program at the Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, please contact Terri Streufert at 612-863-7821.
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