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The molecular mechanisms of angiogenesis: a new approach to cardiovascular diseases.

Although the role of new blood vessel formation in cancer and its development have been well documented, the strategy to manipulate angiogenesis in order to restore blood flow in the ischemic myocardium, a novel form of therapy currently undergoing clinical trials, has received less attention. Recent advances in our understanding of the stimuli and of the control mechanisms regulating the development of new blood vessels in coronary heart disease have led to an improved picture of the compensatory healing process that accompanies myocardial ischemia and infarction. However, we have to remind that, together with life- and tissue-saving effects, the angiogenetic process might alter the natural course of the consequences and organ manifestation of arterial diseases as in the atherosclerotic plaque. The purpose of this review is to provide an overview on the molecular mechanisms involved in the angiogenetic process. Angiogenesis during ontogenesis, neoangiogenesis (adult new vessel formation), arteriogenesis and the related regulators will be analyzed. Moreover, the role of neoangiogenesis in plaque development and instability will be discussed. Due to the introductory nature of this review and the large number of studies on neovascularization in ischemic limbs this topic has been omitted.