Acquired Coronary Angiogenesis after Myocardial Infarction

Abstract

Acquired coronary artery microvascular fistulas have been reported in only a few patients after myocardial infarction. We describe 1 patient in whom serial coronary angiography demonstrated the development of coronary angiogenesis at the site of an old myocardial infarction. The area of neovascularity was associated with a large apical left ventricular thrombus. This finding suggests that growth-promoting mitogens are present in myocardium and thrombus and that angiogenesis occurs in some patients following myocardial infarction.

The role of NF-kappaB in the angiogenic response of coronary microvessel endothelial cells.

“…The growth of blood vessels is a well-documented physiological response to myocardial infarction (3)(4)(5). The mechanism(s) that regulates the response of cardiac tissue to ischemia and the role of a chemical mediator in the angiogenic process have not been established, although several investigations demonstrated the presence and release of an endothelial cell growth…”

Metabolic Determinants of Cardiomyocyte Proliferation

“…In mammals, cardiac regeneration occurs only in the fetal and early neonatal periods of mammals, when a significant loss of cardiomyocytes is countered by veritable heart regeneration; however, the capacity for cardiomyocyte cytokinesis appears to be lost by day 4 after birth. After this time, the cardiac repair response is limited to replacement fibrosis 9 , 10 as well as modest vascular regeneration and remodeling, 11 , 12 which are regulated in part by immune cell-mediated mechanisms. 13-15 …”