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Cardiovascular Research 1999 43(1):44-57; doi:10.1016/S0008-6363(99)00077-2
© 1999 by European Society of Cardiology
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Copyright © 1999, European Society of Cardiology

Multifactorial basis for coronary collateralization: a complex adaptive response to ischemia

Judy R Kersten*, Paul S Pagel, William M Chilian and David C Warltier

Departments of Anesthesiology, Pharmacology and Toxicology, Physiology and Medicine (Division of Cardiovascular Diseases), Medical College of Wisconsin and the Veterans Affairs Medical Center, Milwaukee, WI 53226, USA

* Corresponding author. Corresponding address: Medical College of Wisconsin, MEB – Room 462C, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA. Tel.: +1-414-4565735; fax: +1-414-4566507 jkersten{at}mcw.edu

Angiogenesis and vasculogenesis are adaptive responses of the coronary collateral circulation to myocardial ischemia. This review focuses on the concerted action of growth factors, growth factor receptors, extracellular matrix, and inflammatory cellular responses to regulate angiogenesis and vasculogenesis in response to myocardial ischemia and alterations in shear stress. Therapeutic angiogenesis represents a novel approach to increase myocardial perfusion in patients with coronary artery disease and provides an opportunity to further clarify the mechanisms that regulate collateral development. Impairment of angiogenic adaptive responses to ischemia during disease states is an important subject for future investigation.

KEYWORDS Angiogenesis; Coronary collateral; Growth factors; Myocardial ischemia; Vasculogenesis


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