VEGF-B: A more balanced approach toward cardiac neovascularization?

There is an urgent need for new pharmacologic approaches to combat the clinical consequences of ischemic cardiomyopathy. In this issue of EMBO Molecular Medicine, Kivelä et al show that transgenic expression of VEGF-B in the rat heart leads to expansion of the coronary arterial tree and an increase in functional coronary reserve, accompanied by a shift in myocardial metabolism from fatty acid to glucose utilization. A new report by Kari Alitalo's team shows that VEGF-B induces coronary artery growth that protects the heart from ischemic damage and switches myocardial metabolism from fatty acid to glucose utilization.