Salvage of myocardium and preservation of cardiac function is the ultimate goal of therapies for ischemic heart disease. A keen understanding of the many biological processes involved, ranging from ischemic protection to neovascularization and eventually positive remodeling of the infarcted and non-affected myocardium, will lead to an optimization of therapeutic result. From the many parallels between conditioning protocols and growth factor, cytokine or cell therapy at the level of triggers, mediators and effectors, it is evident that:
a. growth factors are pleiotropic and exert effects that are beneficial to the healing heart through many different mechanisms, b. some of these mechanisms are shared with conditioning protocols and are shared by various conditioning triggers, c. the efficacy readout of growth factor, cytokine or cell therapy should be limited to perfusion and vascular density but should include myocardial viability, function and electrophysiology, and last but not least, d. novel therapeutic approaches may benefit from these insights, for instance by combination of conditioning and neovascularization or by aiming at a long term conditioned state of protection by early growth factor therapy.
Thus, the understanding of the parallels between neovascularization and conditioning sparkle new research as well as therapeutic designs.
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