Differential Expression of the Isoforms of Human Vascular Endothelial Growth Factor and New Approaches to Therapeutic Angiogenesis

Cardiovascular diseases represent the major cause of mortality in industrially developed countries. Among the cardiovascular diseases, those related to the atherosclerotic damage to coronary and peripheral arteries are the most prevalent; coronary heart disease alone accounts for more than 59% of the total mortality and morbidity (in persons over 75 years of age, 75%). Today, if antiischemic therapy fails to improve the patients' condition, various surgical and endovascular interventions are the main methods of treatment. However, a large proportion of patients with atherosclerotic vessel damage are unfit for standard revascularization procedures, or a complete revascularization is impossible because of diffuse damage [1, 2]. Moreover, in many patients, recurrent stenoses and occlusions of shunts develop after initially successful surgery, with signs of stenocardia or heart failure recurring without the possibility of a second operation or angioplastic. Hopes are placed on recent advances in gene engineering and gene therapy, namely, a new therapeutic strategy termed therapeutic angiogenesis, which is aimed at improving blood supply to tissues. Therapeutic angiogenesis is based on the stimulation of natural adaptive mechanisms by administering growth factors or their genes into the region affected with ischemia [3, 4]. This line of research is expected to permit the treatment of coronary heart disease and myocardial infarc