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(Circulation. 1996;94:600-601.)
© 1996 American Heart Association, Inc.

Articles

Collateral Vessel Growth in the Human Heart

Role of Fibroblast Growth Factor–2

Wolfgang Schaper, MD

Max-Planck-Institute, Department of Experimental Cardiology, Bad Nauheim, Germany.

Correspondence to Wolfgang Schaper, MD, Max-Planck-Institute, Department of Experimental Cardiology, Benekestr 2, D-61231 Bad Nauheim, Germany. E-mail wschaper@kerckhoff.mpg.de.

Key Words: Editorials • vessels • growth substances

	Introduction

 
An article in this issue by Fujita et al¹ describes markedly increased concentrations of bFGF in the pericardial fluid of human patients who were operated on because of unstable angina. The authors should be congratulated for this highly original approach, which is bound to shed light on the molecular mechanisms of collateral growth in humans. That growth factors must play a role in collateral vessel development has been evident for many years. However, it is still unclear which of the numerous factors is the decisive one. Furthermore, it is unclear whether this role is defined by a single factor or by a regulated sequence of a cascade of growth factors and which cell type is responsible for growth factor production, not to mention that a multitude of growth factor receptors and binding proteins complicate the analysis. Collateral vessel growth may be an equation with a two-digit number of variables (FGF-1, FGF-2, VEGF, IGF-1 plus six IGF binding proteins, and four FGF and two VEGF receptors=16 variables) that may not all be relevant at the same time, but many do play a role, as we now know.

Moreover, we have to realize that collateral vessels are a heterogeneous group that consists mainly of two classes: those of capillary size or slightly larger and that are devoid of vascular smooth muscle and those that are much larger and have a muscular coat.^{2 3} The latter usually are located epicardially, whereas the capillary collaterals have a predilection for the subendocardium (where they form a . . . [Full Text of this Article]

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