Cardiac Surgery, Massachusetts General Hospital & Harvard Medical School, Boston, USA.
Cardiac Surgery, Golden Jubilee National Hospital & University of Glasgow, Glasgow, UK.
J Cardiovasc Transl Res. 2022 Oct;15(5):1024-1048. doi: 10.1007/s12265-022-10241-0. Epub 2022 Mar 31.
Surgical myocardial revascularization is associated with long-term survival benefit in patients with multivessel coronary artery disease. However, the exact biological mechanisms underlying the clinical benefits of myocardial revascularization have not been elucidated yet. Angiogenesis and arteriogenesis biologically leading to vascular collateralization are considered one of the endogenous mechanisms to preserve myocardial viability during ischemia, and the presence of coronary collateralization has been regarded as one of the predictors of long-term survival in patients with coronary artery disease (CAD). Some experimental studies and indirect clinical evidence on chronic CAD confirmed an angiogenetic response induced by myocardial revascularization and suggested that revascularization procedures could constitute an angiogenetic trigger per se. In this review, the clinical and basic science evidence regarding arteriogenesis and angiogenesis in both CAD and coronary revascularization is analyzed with the aim to better elucidate their significance in the clinical arena and potential therapeutic use.
外科血运重建术可使多支冠状动脉疾病患者获得长期生存获益。然而，血运重建术的临床获益的确切生物学机制尚未阐明。血管生成和动脉生成是导致血管侧支循环形成的生物学机制之一，被认为是在缺血期间保持心肌存活的内源性机制之一，而冠状动脉侧支循环的存在被认为是冠心病患者长期生存的预测因素之一。一些关于慢性 CAD 的实验研究和间接临床证据证实了血运重建术诱导的血管生成反应，并表明血运重建术本身可以构成血管生成触发因素。在这篇综述中，分析了 CAD 和冠状动脉血运重建术的动脉生成和血管生成的临床和基础科学证据，旨在更好地阐明其在临床领域的意义和潜在的治疗用途。
