Gene Therapy for Cardiovascular Diseases

Overview

Neoangiogenesis, congestive heart failure and prevention of reoclusion after PCI represent the main targets of genetherapy (GT) in cardiology. Therapeutic angiogenesis can be used in advanced myocardial ischemia and in anginapectoris not suitable for the revascularization by cardiosurgery or by catheterization techniques. Heart failure isanother indication of GTin cardiology.Modulation of calciumhomeostasis, beta-adrenergic receptors and resistanceof myocytes against apoptosis belongs to main forms of GTin this indication. Prevention of restenosis after PCI(with orwithout stent implantation) represents the third possible indication ofGT.Conversion of ventricularmyocytesinto pacemaker cells using the gene coding potassium channel was described. Some benefit of GTc an be expectedin systemic and pulmonary hypertension. An optimal vector should be defined, as well as the optimal access (probablytransmyocardial supplemented with intravenous application) and doses. GTs eems to be safe and well tolerated bypatients. Randomized, placebo control studies should be initiated for the final clinical assessment of this method.

Key words:
gene therapy, angiogenesis, restenosis, heart failure, apoptosis.