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Heart 2004;90:246-250; doi:10.1136/hrt.2002.007989
Copyright © 2004 BMJ Publishing Group Ltd & British Cardiovascular Society
Heart 2004;90:246-250
© 2004 by BMJ Publishing Group & British Cardiac Society

REVIEW

Recent insights into human coronary collateral development

M Fujita, K Tambara

College of Medical Technology, Kyoto University, Kyoto, Japan

Correspondence to:
Correspondence to:
Dr M Fujita
College of Medical Technology, Kyoto University, 53 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan; mfujita{at}kuhp.kyoto-u.ac.jp

ABSTRACT

Enhancement of coronary collateral function is an intriguing approach to the preservation of ischaemic myocardium. Coronary collateral development consists of collateral recruitment and collateral growth. Collateral growth encompasses proliferation of capillaries in the ischaemic area (angiogenesis) and maturation of pre-existing collateral vessels (arteriogenesis), with the latter being more relevant in humans. Therefore, treatment intended directly for arteriogenesis of collateral vessels appears to be more effective. Promotion of coronary collateral growth has many attractive features, particularly in patients with angina who are not indicated for percutaneous coronary intervention or coronary artery bypass grafting surgery. A complete elucidation of the remaining practical and mechanistic questions of arteriogenesis may lead to a new remedy capable of developing collateral vessels more effectively.

Keywords: coronary collaterals; ischaemia; angiogenesis; arteriogenesis

Abbreviations: bFGF, basic fibroblast growth factor; VEGF, vascular endothelial growth factor


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