Presentation is loading. Please wait.

Presentation is loading. Please wait.

Volume 21, Issue 4, Pages (April 2013)

Similar presentations


Presentation on theme: "Volume 21, Issue 4, Pages (April 2013)"— Presentation transcript:

1 Volume 21, Issue 4, Pages 725-738 (April 2013)
Mechanistic, Technical, and Clinical Perspectives in Therapeutic Stimulation of Coronary Collateral Development by Angiogenic Growth Factors  Gabor M Rubanyi  Molecular Therapy  Volume 21, Issue 4, Pages (April 2013) DOI: /mt Copyright © 2013 The American Society of Gene & Cell Therapy Terms and Conditions

2 Figure 1 Mechanisms of vascular formation in the adult organism. Differences in induction, the participating factors, and the biological processes of angiogenesis, arteriogenesis, and vasculogenesis are illustrated. Factors shown in overlapping areas participate in both processes depicted by the overlapping circles. Ang-1 and Ang-2, angiopoietin-1 and -2; EC, endothelial cell; EPC, endothelial progenitor cell; FGF, fibroblast growth factor; GM-CSF, granulocyte and monocyte colony-stimulating factor; HGF, hepatocyte growth factor; HIF-1α, hypoxia-inducible factor 1α; MCP-1, monocyte chemotactic factor 1; MMPs, matrix metalloproteases; NO, nitric oxide; PDGF, platelet-derived growth factor; TGF-β, transforming growth factor-β; VEGF, vascular endothelial growth factor. Modified from ref. 32 with permission from Oxford University Press. Molecular Therapy  , DOI: ( /mt ) Copyright © 2013 The American Society of Gene & Cell Therapy Terms and Conditions

3 Figure 2 Schematic illustration of the two concepts of adaptive collateral development. The hemodynamic stimulus concept with large collateral arteries developing in normoxic myocardial regions (left) and the ischemic stimulus concept with collateral capillaries/arterioles developing in or near ischemic myocardial regions (blue shaded area) (right), based on measurement of peripheral coronary artery pressure (distal to feed artery stenosis). High peripheral pressure indicates the presence of collateral arteries, proximal to pre-capillary resistance vessels in the feed artery territory (left). Low peripheral pressure suggests that collateral vessels are located distal of pre-capillary resistance arterioles (right). Molecular Therapy  , DOI: ( /mt ) Copyright © 2013 The American Society of Gene & Cell Therapy Terms and Conditions

4 Figure 3 Growth factor gene delivery methods used to target the heart. Intramuscular (green) and intravascular via antegrade (through coronary arteries, red) or retrograde (through coronary veins, blue) routes. Schematic illustration of how these various methods allow the gene delivery vector to reach ischemic/peri-ischemic microvascular regions and/or pre-existing collateral vessels. Molecular Therapy  , DOI: ( /mt ) Copyright © 2013 The American Society of Gene & Cell Therapy Terms and Conditions

5 Figure 4 Schematic illustration of assessment of coronary collateral flow reserve. Diagram illustrating the principle of collateral flow assessment during coronary artery balloon occlusion using an angioplasty pressure or Doppler sensor guide wire, positioned distal to the occluded site. Signals (pressure or flow velocity) detected during angioplasty balloon occlusion in a poorly (left) or well collateralized myocardial region (right) are depicted. During vascular occlusion, the signals are proportional to blood flow through collateral vessels supplying the occluded vascular region. If the measurement is performed during vasodilation of the corresponding microcirculation (achievable during exercise or pharmacological stress), the signal represents maximal achievable collateral flow. CFR, collateral flow reserve. Molecular Therapy  , DOI: ( /mt ) Copyright © 2013 The American Society of Gene & Cell Therapy Terms and Conditions


Download ppt "Volume 21, Issue 4, Pages (April 2013)"

Similar presentations


Ads by Google