Department of Internal Medicine, University of Louisville School of Medicine, 550 South Jackson Street, Louisville, KY 40202, USA.
Nat Rev Cardiol. 2013 Sep;10(9):519-30. doi: 10.1038/nrcardio.2013.94. Epub 2013 Jul 16.
Heart failure is a devastating condition, the progression of which culminates in a mismatch of oxygen supply and demand, with limited options for treatment. Heart failure has several underlying causes including, but not limited to, ischaemic heart disease, valvular dysfunction, and hypertensive heart disease. Dysfunctional blood vessel formation is a major problem in advanced heart failure, regardless of the aetiology. Vascular endothelial growth factor (VEGF) is the cornerstone cytokine involved in the formation of new vessels. A multitude of investigations, at both the preclinical and clinical levels, have garnered valuable information on the potential utility of targeting VEGF as a treatment option for heart failure. However, clinical trials of VEGF gene therapy in patients with coronary artery disease or peripheral artery disease have not, to date, demonstrated clinical benefit. In this Review, we outline the biological characterization of VEGF, and examine the evidence for its potential therapeutic application, including the novel concept of VEGF as adjuvant therapy to stem cell transplantation, in patients with heart failure.
心力衰竭是一种严重的疾病，其进展最终导致氧供和氧需不匹配，治疗选择有限。心力衰竭有几个潜在的原因，包括但不限于缺血性心脏病、瓣膜功能障碍和高血压性心脏病。无论病因如何，心力衰竭晚期的血管生成功能障碍都是一个主要问题。血管内皮生长因子 (VEGF) 是参与新血管形成的基石细胞因子。大量的临床前和临床研究为靶向 VEGF 作为心力衰竭治疗选择的潜在效用提供了有价值的信息。然而，迄今为止，VEGF 基因治疗在冠状动脉疾病或外周动脉疾病患者中的临床试验并未显示出临床益处。在这篇综述中，我们概述了 VEGF 的生物学特征，并研究了其潜在治疗应用的证据，包括 VEGF 作为心力衰竭患者干细胞移植辅助治疗的新概念。
