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Growth factor may determine who grows new blood vessels that protect against heart attacks

ateral-vessel growth. These variables include age, gender, high blood pressure, high blood cholesterol levels, smoking, diabetes and prior efforts to increase the blood flow in the heart, through bypass surgery or balloon angioplasty.

"We are now working out the molecular mechanisms that will allow for the development of a drug that would increase VEGF production in those patients who produce low levels of it and allow them to grow their own collateral blood vessels," says the study's senior author Andrew P. Levy, M.D., Ph.D., of the Rappaport Faculty of Medicine of Technion-Israel Institute of Technology.

The team has already developed a simple laboratory test to identify whether a person produces small or large amounts of VEGF when the heart cells get insufficient oxygen.

Coronary collateral vessels were once thought to pre-exist in the heart and open only to allow blood to flow through them when needed. However, scientists have learned in recent decades that the collateral beds are actually new vessels that grow in the areas of the heart that are deprived of life-sustaining oxygen because of reduced blood flow.

The study findings shed new light on the formation of collateral beds and suggest that certain heart patients might benefit from treatments that enhance their ability to grow new blood vessels. One approach might be gene therapy or a treatment that involves giving people who produce low levels of VEGF a genetically engineered version of the growth factor, according to the researchers.

If further research confirms the study's findings, physicians could easily identify patients unlikely to grow collateral arteries on their own. Such people would be expected to do poorly with currently available medical therapies and be the most likely to benefit from gene therapy or growth factor therapy, says Levy.

"This would allow us to develop oral medications that will enable individuals who produce low levels of VEGF during hypoxia to respon
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Contact: Carole Bullock
caroleb@heart.org
214-706-1279
American Heart Association
2-Aug-1999


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