[Angiogenesis in heart]

Coronary heart disease remains one of the main problems in healthcare systems in western countries. Despite a vast improvement in revascularisation techniques in recent years, we still encounter many patients, who are not suitable for conventional revasularisation methods. A delivery of proangiogenic substances like VEGF or FGF to cardiac muscle was thought to help these patients. Nevertheless, in order to induce angiogenesis in heart in safe and efficient manner further studies of mechanism regulating vessel growth are necessary. This interest resulted in still increasing number of papers dealing with angiogenesis in heart. Still, the results of clinical studies were in large part discouraging. Therefore novel angiogenic substances are currently under investigation. The great expectations are associated with proteins affecting multiple levels and processes involved in vessel growth and maturation. These include among others PIGF and CYR61. Other promising approach is the induction of angiogenesis by stem cells and endothelial progenitor cells. Hopefully these efforts will soon reveal therapeutic methods, which will be applicable in patients with severe ischemic heart disease disqualified from conventional revascularisation procedures.