Multifactorial basis for coronary collateralization: a complex adaptive response to ischemia.
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.
Kersten
J R
JR
Department of Anesthesiology, Medical College of Wisconsin, Milwaukee 53226, USA. jkersten@mcw.edu
Pagel
P S
PS
Chilian
W M
WM
Warltier
D C
DC
D000818:Animals; D003097:Collateral Circulation; D003326:Coronary Circulation; D006133:Growth Substances / Q000502:physiology; D006801:Humans; D017202:Myocardial Ischemia / Q000503:physiopathology*; D009569:Nitric Oxide / Q000378:metabolism; D051381:Rats; D017978:Receptors, Growth Factor / Q000378:metabolism
D006133:Growth Substances; D017978:Receptors, Growth Factor; D009569:Nitric Oxide