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New vascular endothelial growth factor isoforms promise to increase myocardial perfusion without stealing
  1. Giuseppe Mangialardi,
  2. Paolo Madeddu
  1. Bristol Heart Institute, School of Clinical Sciences University of Bristol Level 7, Bristol Royal Infirmary, Bristol, UK
  1. Correspondence to Dr Paolo Madeddu, Bristol Heart Institute, School of Clinical Sciences University of Bristol Level 7, Bristol Royal Infirmary, Upper Maudlin Street, Bristol BS2 8HW, UK; madeddu{at}

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Coronary heart disease (CHD) caused by the narrowing of arteries that feed the heart is the single biggest killer in industrialised societies. Current treatments are palliative, failing to provide a definitive repair of the injured heart. Refractory angina, often seen in patients with occlusive pathology extending to the coronary microvasculature, also represents an unmet therapeutic need. There is hope that regenerative treatments based on gene and stem cell therapy provide a solution for patients with refractory CHD.

Therapeutic angiogenesis with molecules of the vascular endothelial growth factor (VEGF) family has been successfully tested in preclinical rodent models of myocardial and peripheral ischaemia, but clinical trials have not matched the initial promises. This discrepancy is mainly attributable to the dosage and time of delivery, due to the pathophysiological difference between the mouse heart and the human heart. This limitation called for the use of large animal models in cardiovascular research. The swine is considered a valuable organism system in translational medicine due to the similarities with the human organism (ie, size of the heart, type of myocardial perfusion and characteristics …

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  • Funding This paper is supported by the research programme grant ‘Unravelling mechanisms of stem cell depletion for preservation of regenerative fitness in patients with diabetes’ from the British Heart Foundation to PM.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

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