© 1998 by European Society of Cardiology
Copyright © 1998, European Society of Cardiology
Endothelial regrowth after arterial injury: from vascular repair to therapeutics
aDepartment of Cardiology, University of Lille, Lille, France
bDepartment of Cardiovascular Research, St Elizabeth's Medical Center, Tufts University School of Medicine, Boston, MA, USA
* Corresponding author. Service de Cardiologie B, Hôpital Cardiologique, Boulevard du Professeur J. Leclercq, 59037 Lille Cedex, France. Tel. (+33-3) 2044 5302; Fax (+33-3) 2053 5874; E-mail: cbauters@chru-lille.fr
Received 26 September 1997; accepted 9 December 1997
| The first 150 words of the full text of this article appear below. |
Interventional strategies for patients with coronary artery disease such as percutaneous transluminal coronary angioplasty or coronary stent implantation invariably result in a marked degree of vascular injury (deendothelialization, mechanical damage to the medial and adventitial layers) [1–3].
The loss of the endothelial monolayer is associated with a variety of deleterious consequences such as thrombus formation, neointimal thickening, and abnormal responses to endothelium-dependent agonists [3–5]. These effects may contribute to each of the known limitations of these techniques (vessel occlusion, restenosis, coronary spasm).
The objective of the present review will be to present applied reendothelialization as a possible treatment for patients with coronary artery disease undergoing mechanical revascularization. Our aim will be twofold: first, to summarize current knowledge on the beneficial effect of endothelial regrowth after arterial injury; second, to discuss the potential role of growth factors or other compounds to accelerate reendothelialization.
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1 The ‘normal’ endothelial layer |
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Occupying a strategically important location between
1.1 Endothelium-dependent vasomotion
1.1.1 Relaxing factors
1.1.2 Contracting factors
1.2 Growth inhibitory effect on underlying vascular VSMCs
1.2.1 Heparin/heparan sulfate proteoglycans
1.2.2 EDRF-NO
1.3 Endothelium as an antithrombotic layer
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2 Spontaneous endothelialization after arterial injury |
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2.1 The vascular response after arterial injury
2.2 The natural history of endothelial regrowth after arterial injury
2.3 Interaction between endothelial regrowth and the other components of the response to injury
2.3.1 Thrombogenicity
2.3.2 Neointimal hyperplasia
2.3.3 Vascular remodeling
2.3.4 Neoendothelial function
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3 Applied reendothelialization using endothelial growth factors |
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3.1 Reendothelialization after balloon injury
3.1.1 FGF
3.1.2 VEGF
3.2 Accelerated endothelialization of endovascular stents
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4 Beside growth factors |
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4.1 ACE inhibition
4.2 Estrogen
4.3 Endothelial cell seeding
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5 Future prospects |
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