Hemodynamic forces as a stimulus for arteriogenesis

Ischemic heart diseases put a heavy economical burden on Western society. They remain one of the major causes of morbidity, and preventive or postoperative treatments are lengthy and expensive. In some patients of ischemic heart diseases, there is not a direct correlation between the degree of occlusion of major arteries and the development of medical symptoms or damage to the heart function. Interestingly, these patients develop well-formed collateral vessels that compensate for the decrease in blood supply to the heart wall. Clearly, the ability to understand why and how these patients develop collateral vessels may serve as a base for a new strategy to treat ischemic heart diseases by promoting collateral formation. The current article summarizes recent advances in the understanding of how collateral vessels develop and offers the authors' point of view on the central role of biomechanical forces in this process and the molecular mechanisms that underline it.