Preventive treatment of graft coronary vascular disease: the potential role of vasodilator therapy.
The prevention or treatment of graft coronary vascular disease is one of the major challenges facing cardiovascular medicine today. Further investigation is necessary to elucidate the mechanisms by which myointimal hyperplasia develops within the coronary vasculature of heart transplants. Studies of several models of the vascular disease, however, suggest that there is an interaction between vasoactive substances, hemodynamic stimuli, and autocrine/paracrine growth factors that governs the vascular remodeling response to vessel injury. In this review I will focus primarily on the role of vasoactive substances and hemodynamic stimuli as determinants of vascular structure. In addition, this review will provide substantiating evidence that advances the postulate that vasodilator therapy may have an adjunctive role in the prevention and treatment of graft coronary vascular disease. It is hoped that this provocative concept will stimulate further investigation of novel therapeutic strategies in the treatment of this disease.
Gibbons
G H
GH
Cardiovascular Medicine Division, Stanford University School of Medicine, CA 94305.
D003327:Coronary Disease / Q000378:metabolism / Q000517:prevention & control* / Q000628:therapy; D003331:Coronary Vessels / Q000503:physiopathology; D016027:Heart Transplantation; D006801:Humans; D011183:Postoperative Complications / Q000517:prevention & control*; D013314:Stress, Mechanical; D014662:Vasoconstrictor Agents / Q000378:metabolism; D014665:Vasodilator Agents / Q000378:metabolism / Q000627:therapeutic use*
D014662:Vasoconstrictor Agents; D014665:Vasodilator Agents