Prevention and recovery of hibernating myocardium by microvascular repair.

Coronary artery disease, ischemic cardiomyopathy, and congestive heart failure continue to confer significant morbidity and mortality despite advances in medical therapy, percutaneous coronary interventions, and surgical revascularization.1,2 This unmet clinical need is the rationale for novel therapeutic strategies like therapeutic angiogenesis. Unlike traditional revascularization, which focuses on macrovascular solutions, angiogenesis seeks to improve the microcirculation by stimulating new capillary and collateral arterial vessel formation. Recently, there has been significant discussion on traditional revascularization, in particular the benefit of revascularization with coronary artery bypass surgery (CABG) in patients with left ventricular (LV) dysfunction in the Surgical Treatment for Ischemic Heart Failure (STICH) Trial.3 As opposed to mechanical revascularization, whether by CABG or percutaneous coronary intervention, therapeutic angiogenesis has the advantage of improving coronary microcirculation by harnessing existing physiological processes to address a biological problem.