Klinische Ergebnisse der Behandlung der koronaren Herzkrankheit mit Wachstumsfaktoren

Zusammenfassung

Die aktuellen Behandlungsmethoden der koronaren Herzkrankheit zielen auf Minimierung des Infarktrisikos und Reduktion der Symptome durch Senkung des myokardialen Sauerstoffbedarfs, durch Verbesserung der myokardialen Perfusion sowohl medikamentös als auch mechanisch durch PTCA oder Bypasschirurgie und durch Prävention einer weiteren Progression der Erkrankung. Trotz des hohen technischen Standards der interventionellen oder operativen Verfahren der myokardialen Revaskularisation sind diese bei Patienten mit diffuser Arteriosklerose und peripherem Gefäßbefall nicht anwendbar. Die Induktion der Angiogenese durch humane angiogenetische Wachstumsfaktoren entwickelt sich speziell bei dieser Patientengruppe zu einer neuen Therapiemodalität und stellt neben medikamentöser Therapie, PTCA und Bypasschirurgie ein viertes, neuartiges Behandlungsprinzip der koronaren Herzkrankheit dar. »Polypeptide Fibroblast Growth Factor« (FGF) und »Vascular Endothelial Growth Factor« (VEGF) scheinen einen besonders starken Effekt im Hinblick auf die Induktion der Angiogenese im hypoxischen Gewebe auszuüben.

Summary

Currently available approaches for treating coronary heart disease aim to relieve symptoms and the risk of myocardial infarction by reducing myocardial oxygen demand, increasing myocardial perfusion pharmcologically or mechanically by angioplasty or bypass surgery and by preventing further progression of the disease. Despite the high technical standarts of bypass surgery and interventional procedures, patients with diffuse atherosclerosis are not amenable to these techniques. Therapeuthic induction of angiogenesis by human angiogenic growth factors is evolving to be a fourth, new principle of treatment of atherosclerotic cardiovascular disease, especially for this group of patients. The polypeptides fibroblast growth factor (FGF) and vascular endothelial growth factor (VEGF) seem to be powerful stimulators of angiogenesis in hypoxic tissue.

Schlüsselwörter

Angiogenese - Wachstumsfaktoren - Fibroblast Growth Factor - koronare Herzkrankheit

Keywords

Angiogenesis - growth factors - fibroblast growth factor - coronary heart disease

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