Delivery strategies to achieve therapeutic myocardial angiogenesis

Ran Kornowski*, Shmuel Fuchs, Martin B. Leon, Stephen E. Epstein

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

123 Scopus citations


The use of recombinant genes or growth factors to enhance myocardial collateral blood vessel function may represent a new approach to the treatment of cardiovascular disease. Proof of concept has been demonstrated in animal models of myocardial ischemia, and clinical trials are underway. Currently, it is unknown which is the safest and most effective delivery strategy to induce clinically important therapeutic angiogenic responses in ischemic myocardium. Most strategies for transcatheter delivery of anglogenic factors have used an intracoronary route, which may have limitations because of imprecise localization of genes or proteins and systemic delivery to noncardiac tissue. The effect of direct intraoperative intramyocardial injection of anglogenie factors on collateral function has been reported in experimental models, and angiogenesis is being studied after direct intramyocardial injection of angiogenic peptides or plasmid vectors during open heart surgery in patients. Catheter-based transendocardial injection of angiogenic factors may provide equivalent benefit without the need for surgery. Intrapericardial delivery of angiogenic factors may offer a theoretical advantage of prolonged exposure of either coronary or myocardial tissue to the administered drug as result of a reservoir function of the pericardium. In this article, we review the different modes of administration for therapeutic myocardial angiogenesis therapy.

Original languageEnglish
Pages (from-to)454-458
Number of pages5
Issue number4
StatePublished - 1 Feb 2000
Externally publishedYes


  • Angiogenesis
  • Gene therapy
  • Myocardium


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