The cardiac microvasculature in hypertension, cardiac hypertrophy and diastolic heart failure.
Recent studies revealed an exceedingly high mortality with diastolic heart failure that was previously regarded as relatively benign compared to systolic heart failure. Prominent risk factors for diastolic heart failure are increasing age, hypertension and diabetes. These risk factors are associated with coronary microvascular rarefaction and resultant decreased coronary flow reserve, thereby rendering the myocardium vulnerable to ischemia. We discuss the importance of angiogenic gene programming in preserving the coronary microvasculature, preserving cardiac function and altering disease course. Further, we discuss the possible utility of therapies that activate hypoxia inducible factor-1 in preventing rarefaction of the coronary microvasculature and maintaining cardiac diastolic function.
Hoenig
Michel R
MR
Clinical Sciences, Royal Brisbane & Women's Hospital, Brisbane, Australia. drmhoenig@yahoo.com.au
Bianchi
Cesario
C
Rosenzweig
Anthony
A
Sellke
Frank W
FW
D000375:Aging; D000818:Animals; D006332:Cardiomegaly / Q000235:genetics / Q000503:physiopathology* / Q000628:therapy; D003326:Coronary Circulation / Q000235:genetics; D048909:Diabetes Complications / Q000503:physiopathology; D042783:Endothelial Cells / Q000378:metabolism; D015316:Genetic Therapy; D054144:Heart Failure, Diastolic / Q000235:genetics / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D006973:Hypertension / Q000235:genetics / Q000503:physiopathology* / Q000628:therapy; D017379:Hypertrophy, Left Ventricular / Q000503:physiopathology; D008833:Microcirculation / Q000503:physiopathology; D018919:Neovascularization, Physiologic / Q000235:genetics; D013234:Stem Cells / Q000378:metabolism; D042461:Vascular Endothelial Growth Factor A / Q000235:genetics / Q000378:metabolism
D042461:Vascular Endothelial Growth Factor A