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Multifactorial basis for coronary collateralization: a complex adaptive response to ischemia
J R Kersten1, P S Pagel, W M Chilian
1Department of Anesthesiology, Medical College of Wisconsin, Milwaukee 53226, USA. jkersten@mcw.edu
Insights
This review explores how growth factors and cellular responses drive blood vessel formation (angiogenesis and vasculogenesis) in the heart after ischemia. Understanding these processes may lead to new therapies for coronary artery disease.
Area of Science:
- Cardiovascular Biology
- Regenerative Medicine
Background:
- Myocardial ischemia triggers adaptive responses in coronary collateral circulation.
- Angiogenesis and vasculogenesis are key processes in this adaptation.
Purpose of the Study:
- To review the regulation of angiogenesis and vasculogenesis in response to myocardial ischemia.
- To highlight therapeutic angiogenesis as a potential treatment for coronary artery disease.
Main Methods:
- Review of literature on growth factors, receptors, extracellular matrix, and inflammatory cells.
- Analysis of mechanisms regulating collateral development in response to ischemia and shear stress.
Main Results:
- Growth factors, receptors, extracellular matrix, and inflammatory cells orchestrate angiogenesis and vasculogenesis.
- Therapeutic angiogenesis offers a novel approach to enhance myocardial perfusion.
Conclusions:
- Understanding the regulation of collateral development is crucial for treating coronary artery disease.
- Further investigation into impaired angiogenic responses during disease states is warranted.
Abstract:
Angiogenesis and vasculogenesis are adaptive responses of the coronary collateral circulation to myocardial ischemia. This review focuses on the concerted action of growth factors, growth factor receptors, extracellular matrix, and inflammatory cellular responses to regulate angiogenesis and vasculogenesis in response to myocardial ischemia and alterations in shear stress. Therapeutic angiogenesis represents a novel approach to increase myocardial perfusion in patients with coronary artery disease and provides an opportunity to further clarify the mechanisms that regulate collateral development. Impairment of angiogenic adaptive responses to ischemia during disease states is an important subject for future investigation.