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Clinical Applications of Cardiovascular Angiogenesis
Author(s) -
Zimmerman Michael A.,
Selzman Craig H.,
Raeburn Christopher D.,
Calkins Casey M.,
Barsness Katherine,
Harken Alden H.
Publication year - 2001
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/j.1540-8191.2001.tb00555.x
Subject(s) - medicine , angiogenesis , neovascularization , collateral circulation , therapeutic angiogenesis , disease , clinical trial , cardiology , pathophysiology
Anglogenesis is fundamental to both normal physiologic (wound healing) and pathologic (cancer) processes. Manipulation of divergent angiogenic signals promises effective therapy of atherosclerotic cardiovascular disease. Positive proangiogenic strategies promise collateral circulation to ischemic territories, while negative antiangiogenic strategies starve the fibromuscular proliferation within the atherosclerotic lesion. Indeed, recent phase 1 trials suggest that delivering DNA or recombinant protein to the site of vascular occlusion may stimulate physiologically significant collateral circulation in chronically ischemic myocardium. While symptomatic and functional improvement has been documented, toxicity profiles and effects on long‐term patient survival are still unclear. The purposes of this article are as follows: (1) to review the pathophysiologic basis for pro‐ and antiangiogenic strategies in the treatment of cardiovascular disease, (2) to examine the clinical trials of proangiogenic gene or recombinant protein delivery into ischemic beds, and conversely, (3) to explore antiangiogenic strategies in the prevention and treatment of intimal neovascularization and smooth muscle proliferation within the vessel wall.