Cardiovascular Research Center, Rhode Island Hospital, Providence, RI 02903, USA.
Division of Cardiothoracic Surgery, Alpert Medical School of Brown University, Providence, RI 02903, USA.
Int J Mol Sci. 2021 Apr 2;22(7):3722. doi: 10.3390/ijms22073722.
Cardiovascular diseases continue to be the leading cause of death worldwide, with ischemic heart disease as the most significant contributor. Pharmacological and surgical interventions have improved clinical outcomes, but are unable to ameliorate advanced stages of end-heart failure. Successful preclinical studies of new therapeutic modalities aimed at revascularization have shown short lasting to no effects in the clinical practice. This lack of success may be attributed to current challenges in patient selection, endpoint measurements, comorbidities, and delivery systems. Although challenges remain, the field of therapeutic angiogenesis is evolving, as novel strategies and bioengineering approaches emerge to optimize delivery and efficacy. Here, we describe the structure, vascularization, and regulation of the vascular system with particular attention to the endothelium. We proceed to discuss preclinical and clinical findings and present challenges and future prospects in the field.
心血管疾病仍然是全球范围内的主要死亡原因，其中缺血性心脏病是最重要的致病因素。药物和手术干预已经改善了临床结果，但无法改善晚期心力衰竭。旨在再血管化的新治疗方法的成功临床前研究在临床实践中显示出短暂的、无效果的作用。这种失败可能归因于目前在患者选择、终点测量、合并症和输送系统方面的挑战。尽管仍然存在挑战，但治疗性血管生成领域正在发展，因为新的策略和生物工程方法的出现，以优化输送和疗效。在这里，我们描述了血管系统的结构、血管生成和调节，特别关注内皮细胞。接着，我们讨论了临床前和临床发现，并提出了该领域的挑战和未来前景。
