title: Enhancement of noncoronary collateral circulation: the hypothesis of an alternative treatment for ischemic heart disease.
abstract: The internal thoracic arteries (ITAs) are a source of "noncoronary collateral circulation" (NCCC), or "noncoronary collateral blood flow" (NCCBF). The hypothesis herein is that enhancement of NCCC may represent an alternative means of myocardial blood supply: (1) Ligature of the ITAs creates a local hypertensive status and increases the perfusion pressure within the channels leading to the heart; (2) Myocardial ischemic stimulus diverts most ITA-related collateral flow to the heart rather than to the chest wall; (3) The ITAs may develop neo-collaterals owing to their ischemia-related plastic potential; (4) Angiogenic growth factor administration within the ITAs enhances neo-collateral development. These elements may pave the way for a new field of cardiovascular research aimed at enhancing NCCC as a new therapeutic option for ischemic heart disease.
authors.affiliation: Cardiac Surgery Department, Laval University Hospital, Québec City, Québec, Canada. marco.piciche@libero.it
authors.forename: Marco
authors.initials: M
authors.lastname: Picichè
authors.forename: John G
authors.initials: JG
authors.lastname: Kingma
authors.forename: Elie
authors.initials: E
authors.lastname: Fadel
authors.forename: Francois
authors.initials: F
authors.lastname: Dagenais
authors.forename: Justin
authors.initials: J
authors.lastname: Robillard
authors.forename: Denis
authors.initials: D
authors.lastname: Simard
authors.forename: Pierre
authors.initials: P
authors.lastname: Voisine
mesh_terms: D003097:Collateral Circulation; D003326:Coronary Circulation; D006321:Heart / Q000503:physiopathology; D006801:Humans; D006973:Hypertension; D036341:Intercellular Signaling Peptides and Proteins; D008962:Models, Theoretical; D017202:Myocardial Ischemia / Q000503:physiopathology* / Q000628:therapy*; D009206:Myocardium / Q000473:pathology; D018919:Neovascularization, Physiologic
chemical_list: D036341:Intercellular Signaling Peptides and Proteins