Therapeutic neovascularization for ischemic heart disease

The demonstration that angiogenic growth factors stimulate new blood vessel growth and restore perfusion in animal models of myocardial and peripheral vascular ischemia has prompted the translation of therapeutic angiogenesis from bench to bedside. The enthusiasm generated from early, open-label, safety trials using primarily vascular endothelial growth factors or fibroblast growth factor protein or gene therapy has been tempered by double-blind randomized placebo controlled studies that have yielded variable though potentially promising results. This article reviews the basis of angiogenic therapy, lessons learned from the latest major trials and potential refinements for future therapy.