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Rebecca Voelker

JAMA. 1999;282:933.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

The secret to some patients' ability to form coronary artery collateral beds may lie in the amount of vascular endothelial growth factor (VEGF) they produce during hypoxia.

In a study of 51 patients with 70% or greater blockage in at least one coronary artery, Israeli researchers performed diagnostic angiography to determine the extent of each patient's collateral blood supply. Patients were separated into three groups according to collateral beds, and their VEGF levels were tested. Researchers found no difference in VEGF production when heart muscle cells received sufficient oxygen.

However, they found that patients who produced the most VEGF during hypoxia had the most extensive collateral blood supply. The correlation between VEGF production and collateral blood vessel growth remained when the researchers controlled for age, sex, hypertension, blood cholesterol levels, smoking, diabetes, and previous attempts to increase blood flow in the heart through bypass surgery or balloon angioplasty.

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