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Therapeutic neovascularization for coronary disease: current state and future prospects

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Abstract

Despite advances in surgical and percutaneous revascularization techniques, nearly one-third of patients with ischemic coronary artery disease are not candidates for revascularization due to suboptimal anatomy or receive suboptimal revascularization from these standard procedures. Neovascularization of the myocardium is not only a physiologic response to ischemia, but also potentially the target of new therapeutic strategies. Induced angiogenesis via protein, gene, and cell-based therapies showed initial promise in experiments using otherwise healthy laboratory animals. However, failure to translate these gains into humans prompted further study into the vascular environment and endothelial dysfunction. Understanding that factors such as hypertension, diabetes, and hyperlipidemia are not only placing patients at risk for coronary artery disease but also undermining our attempts in neovascularization therapies, has prompted us to rethink our therapeutic approach. Future directions for therapeutic neovascularization lie in therapies combining optimization of the vascular environment, improvement of endothelial function and other aspects of vascular formation and development.

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Acknowledgments

Funding for this project was provided to Frank W. Sellke through the National Heart, Lung and Blood Institute of the National Institute of Health (R01-HL046716, R01-HL069024, R01-HL85647), to Antonio D. Lassaletta through a National Institute of Health training grant (5T32-HL076134-05), and to Louis M. Chu through a National Institute of Health training grant (T32-HL094300).

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Authors and Affiliations

  1. Department of Surgery, Division of Cardiothoracic Surgery, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA

    Antonio D. Lassaletta, Louis M. Chu & Frank W. Sellke

  2. Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

    Antonio D. Lassaletta & Louis M. Chu

  3. Cardiovascular Research Center, Warren Alpert Medical School of Brown University, 593 Eddy Street, APC 424, Providence, RI, 02903, USA

    Frank W. Sellke

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  1. Antonio D. Lassaletta
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Correspondence to Frank W. Sellke.

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Lassaletta, A.D., Chu, L.M. & Sellke, F.W. Therapeutic neovascularization for coronary disease: current state and future prospects. Basic Res Cardiol 106, 897–909 (2011). https://doi.org/10.1007/s00395-011-0200-1

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