doi: 10.1161/CIRCULATIONAHA.105.542852
(Circulation. 2005;111:3188-3191.)
© 2005 American Heart Association, Inc.
Editorial |
Molecular Images of Neovascularization
Art for Art’s Sake or Form With a Function?
From the Cardiovascular Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pa.
Correspondence to Flordeliza S. Villanueva, MD, Associate Professor of Medicine, Cardiovascular Institute, University of Pittsburgh School of Medicine, S568 Scaife Hall, 200 Lothrop St, Pittsburgh, PA 15213. E-mail villanuevafs@msx.upc.edu
Key Words: Editorials • angiogenesis • imaging • echocardiography • scintigraphy
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
Therapeutic modulation of vascular growth with growth factors or genes encoding for them is an attractive strategy for treating individuals afflicted with obstructive atherosclerotic coronary artery and peripheral vascular disease. Despite the initial promise of "therapeutic angiogenesis" in experimental animal models and small open-label clinical trials, recent larger blinded placebo-controlled trials in such patients have failed to demonstrate a clear-cut treatment benefit.1–3 The reasons for this are complex, incompletely understood, and the subject of controversy, the scope of which is beyond this editorial and is discussed in other excellent reviews.1,2 It is worth, however, considering some questions raised by the discordance between preclinical and clinical results because the articles on molecular imaging of neovascularization by Hua et al4 and Leong-Poi et al5 in the present issue of Circulation could ultimately shed useful light on this debate.
See p 3248 and 3255
A question that has been raised in deliberations over why angiogenesis trials in humans have not demonstrated the robust therapeutic effects seen in earlier animal studies is whether the end points chosen for these trials were "correct"; ie, what is the definition of "successful" therapeutic neovascularization? Furthermore, were the measurement tools that were used to capture such end points adequately sensitive to detect them, even if they were present? Most scientists and clinicians would agree that successful neovascularization requires that new blood vessels be functional, supply the ischemic region with blood, and be stable over time. Our patients would emphasize that irrespective of whether the treatment makes them live
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