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J Thorac Cardiovasc Surg 2003;125:S55-S56
© 2003 The American Association for Thoracic Surgery

Editorials

Therapeutic cardiac angiogenesis and myogenesis: The promises and challenges on a new frontier

Ray C.-J. Chiu, MD, PhD

From McGill University, Montreal, Quebec, Canada.

Received for publication June 8, 2001. Accepted for publication June 27, 2001. Address for reprints: Ray Chu-Jeng Chiu, MD, PhD, Department of Surgery, Montreal General Hospital, McGill University, 1650 Cedar Ave, C9-169, Montreal, PQ H3G 1A4, Canada.

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  		Dr Chiu

 
Myocardial circulatory insufficiency, cardiomyocyte necrosis, and apoptosis play important roles in many pathologic conditions of the heart. Therapeutic approaches aimed at promoting angiogenesis and growing new heart muscle fibers, currently undergoing intensive investigation and early clinical trials, therefore hold considerable promise for the future. Genes encoding angiogenic factors and angiogenic growth factor proteins, such as vascular endothelial growth factor (VEGF) and basic fibroblast growth factor, are being delivered to the target tissue to induce growth of new blood vessels. For myogenesis, various progenitor and stem cells are being assessed as donor cells for implantation into the ventricular wall of injured hearts. Phase I and II clinical trials have already been undertaken for myocardial angiogenesis. Clinical studies into myogenesis have been recently initiated with implantation of autologous skeletal myoblasts into myocardial scar tissue. Although the results of phase I safety studies so far are promising, the establishment of efficacy requires rigorous phase II and III studies yet to come.

Cardiac myogenesis and angiogenesis represents a paradigm shift in our therapeutic approach, from substitution to regeneration of irreversibly damaged cardiac tissues and . . . [Full Text of this Article]






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