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Trials of Angiogenesis Therapy in Patients with Ischemic Heart Disease

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Biochemical Basis and Therapeutic Implications of Angiogenesis

Part of the book series: Advances in Biochemistry in Health and Disease ((ABHD,volume 6))

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Abstract

Therapeutic angiogenesis is a novel method to create endogenous bypass conduits around the occluded coronary arteries. After the success in animal studies, therapeutic angiogenesis has been studied in humans with ischemic heart disease not responding to (or in addition to) conventional treatments. The most commonly studied angiogenic cytokines are vascular endothelial growth factor, fibroblast growth factor and granulocyte colony stimulating factor. Delivery as a protein, or vector with gene encoding for specific protein have been tested in clinical trials. These cytokines, using a multitude of delivery routes ranging from direct intramyocardial transfer either from epicardial or endocardial side, intracoronary infusion, systemic administration via subcutaneous route, have been introduced to myocardial tissues. Small sample size phase I studies have shown promising results. But large sample size, controlled studies have failed to demonstrate any significant improvement in various clinical, radiographic and angiographic outcomes in ischemic heart disease patients. Angiogenesis is influenced by a multitude of variables including duration of exposure, type of vector and need for co-factor. They also vary based on the individual patient characteristics. Further studies accounting for these variables are needed to fully determine the potential of therapeutic angiogenesis in ischemic heart disease.

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  1. Division of Cardiology, University of Arkansas for Medical Sciences and the Central Arkansas Veterans Healthcare System, 2200 Riverfront drive, Apt 1202, Little Rock, AR, 72202, USA

    Ajoe John Kattoor MD & Pankaj Mathur MD

  2. Division of Cardiovascular Medicine, University of Arkansas for Medical Sciences and the Central Arkansas Veterans Healthcare System, 2200 Riverfront drive, Apt 1202, Little Rock, AR, 72202, USA

    Jawahar L. Mehta MD, PhD

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Correspondence to Ajoe John Kattoor MD .

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Editors and Affiliations

  1. Divison of Cardiovascular Medicine, University of Arkansas for Medical Sciences, Central Arkansas Veterans Healthcare System, Little Rock, Arkansas, USA

    Jawahar L. Mehta

  2. Department of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA

    Pankaj Mathur

  3. Institute of Cardiovascular Sciences, St. Boniface Hospital Albrechtsen Research Centre, Department of Physiology and Pathophysiology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada

    Naranjan S. Dhalla

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© 2017 Springer International Publishing AG

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Kattoor, A.J., Mathur, P., Mehta, J.L. (2017). Trials of Angiogenesis Therapy in Patients with Ischemic Heart Disease. In: Mehta, J., Mathur, P., Dhalla, N. (eds) Biochemical Basis and Therapeutic Implications of Angiogenesis. Advances in Biochemistry in Health and Disease, vol 6. Springer, Cham. https://doi.org/10.1007/978-3-319-61115-0_18

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