Novel approaches to ischemic tissue repair

描述(申请人提供)：在考虑移植或植入LVAD之前，充血性心力衰竭(CHF)患者的医疗治疗是优化的，如果左心功能不全继发于缺血，可能会进行血管重建，包括搭桥手术和/或经皮介入治疗。在CHF的背景下考虑血运重建的基本原理是基于冬眠心肌的概念，即由于低灌流而低收缩的存活心肌。我们的实验室一直在追求微血管修复的概念，将其作为改善缺血性疾病患者症状和功能的一种手段。这些努力包括应用血管生成因子和基于细胞的策略，试图利用自然发生的机制进行组织修复。目前的建议是我们实验室先前工作的延伸，也是我们长期目标的延续，即确定缺血组织修复的机制，并基于这些发现开发新的治疗方法。如果成功，这项提案中概述的实验可能会找到新的治疗方法来改善充血性心力衰竭患者的血流和功能。公共卫生相关性：这项建议是我们实验室先前工作的延伸，也是我们长期目标的延续，即确定缺血组织修复的机制，并寻找和开发新的治疗方法，以改善充血性心力衰竭患者的血流和功能。

DESCRIPTION (provided by applicant): Before consideration for transplant or LVAD insertion, patients with congestive heart failure (CHF) are optimized in medical treatment and, if the left ventricular dysfunction is secondary to ischemia, revascularization, consisting of bypass surgery and/or percutaneous intervention, may be performed if feasible. The rationale for considering revascularization in the setting of CHF is based on the concept of hibernating myocardium, i.e. viable myocardium that is hypo-contractile due to hypoperfusion. Our laboratory has been pursuing the concept of microvascular repair as a means of improving symptoms and function in patients with ischemic disease. These efforts have included the application of angiogenic factors and cell based strategies in an attempt to leverage naturally occurring mechanisms for tissue repair. The present proposal is an extension of prior work in our lab and a continuation of our long-standing goal to define mechanisms of ischemic tissue repair and develop novel therapeutics based on these discoveries. If successful the experiments outlined in this proposal could identify novel therapeutics to improve blood flow and function in patients with congestive heart failure. PUBLIC HEALTH RELEVANCE: This proposal is an extension of prior work in our lab and a continuation of our long-standing goal to define mechanisms of ischemic tissue repair and to identify and develop novel therapeutics to improve blood flow and function in patients with congestive heart failure.