Nature is totally amoral! There are at least 3-4 million people in France alone who suffer from arterial hypertension, and whose cardiovascular system is submitted day and night to both a haemodynamic and hormonal stress. In all cases, the vasculature hypertrophies as does the myocardium. This growth process is obviously mainly detrimental at the outset since it lowers compliance of the arteries and makes them stiffer. In contrast, myocardial hypertrophy is initially beneficial since the growth process multiplies the number of contractile units and by so doing improves external work. In addition, according to Starling's law, wall stress is lowered. Growth factors playa major role in this amoral process as a trigger for hypertrophy at the vascular level, and very likely at the level of the myocardium. Another major point of interest is the role of growth factors as determinants of restenosis after angioplasty and also of atherogenesis. Several chapters in this book are directly or indirectly concerned with this problem which is far from being purely academic since several groups are currently trying to control these processes by gene transfer. Certainly, one of the major clinical questions arising from such studies is why restenosis is not more frequent in clinical practice. After de-endotheliazation, the biologist would predict on the basis of recent studies on growth factors, and in contrast with current clinical opinion, that hypertrophy would occur in all cases with more or less complete restenosis.

Inhalt

1. Growth Factors: In vivo function and mechanism of action.- Section one: Growth factors in the heart.- 2. Fibroblast and transforming growth factors in the heart: A role in cardiac growth?.- 3. Growth factors and the cardiac extra-cellular matrix.- Section two: Growth factors and the cardiac myocyte.- 4. Transforming growth factor-ß : Localization and possible functional roles in cardiac myocytes..- 5. Basic fibroblast growth factor in cardiac myocytes: expression and effects.- 6. Growth factor signal transduction in the cardiac myocyte: Functions of the serum response element.- 7. Effects of growth factors on human cardiac myocytes.- Section three: Growth factors and angiogenesis.- 8. Growth factors and development of coronary collaterals.- 9. The role of growth factors in angiogenesis.- Section four: Growth factors and atherosclerosis.- 10. Atherosclerosis and platelet derived growth factors.- 11. Effects of TGF-ß on vascular smooth muscle cell growth.- 12. Some aspects of growth signal transduction in vascular smooth muscle cells.- 13. Basic FGF's role in smooth muscle cell proliferation: A basis for molecular atherectomy.- Section five: Growth factors and cardiovascular disease: Clinical and therapeutic implications.- 14. Role of transforming growth factor ß in cardioprotection of the ischemic-reperfused myocardium.- 15. Platelet-derived growth factor release after angioplasty.- 16. Platelet-derived growth factor (PDGF) receptor induced by vascular injury.- 17. Growth factors and hypertension: Implications for a role in vascular remodelling.- 18. Transforming growth factor-ß induction in carcinoid heart disease.- Section six: Growth factor effects on the myocardium.- 19. Adrenergic stimulation and growth factor activity.- 20. Effects of transforming growthfactor-beta on cardiac fibroblasts.- 21. Transforming growth factor ßs and cardiac development.