Effects of extracorporeal cardiac shock wave therapy in patients with ischemic heart failure
10.3760/cma.j.issn.0253-3758.2012.02.013
- VernacularTitle:体外心脏震波治疗缺血性心力衰竭的初步观察
- Author:
Yun-Zhu PENG
1
;
Tao GUO
;
Ping YANG
;
Hong-Wen YANG
;
Ping ZHOU
;
Yu WANG
;
Zhi-Ling LUO
;
Yun GU
;
Jia-Hua PAN
Author Information
1. 昆明医学院附属第一医院
- Keywords:
Heart failure,congestive;
Myocardial ischemia;
Extracorporeal cardiac shock wave therapy
- From:
Chinese Journal of Cardiology
2012;40(2):141-146
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the feasibility,safety and efficiency of extracorporeal cardiac shock wave therapy (CSWT)in patients with ischemic heart failure.Methods Fifty patients with ischemic heart failure and left ventricular ejection fraction (LVEF) ＜ 50％ were randomized to CSWT (shots/spot at 0.09 mJ/mm2 for 9 spots,9 times within 3 month) or control group.Dual isotope simultaneous acquisition single-photon emission computed tomography with 99 18Tcm -sestamibi/ F-fluorodeoxyglucose (99 Tcm-MIBI/18F-FDG) was performed before randomization and at 1 month after CSWT/control to locate and evaluate viable myocardium region.Canadian cardiovascular society (CCS) class sores,NYHA,Seattle Angina Questionnaire( SAQ),6-min walk test(6 MWT),left ventricular ejection fraction (LVEF),left ventricular end-diastolic dimension (LVEDD)and the dosage of nitroglycerin use were compared between two groups at each time point.Results All patients completed the study protocol without procedural complications.At 1 month,patients in CSWT group experienced improvement in NYHA (P ＜ 0.01 ),CCS(P ＜ 0.01 ),SAQ (P =0.021 ),6 MWT( P =0.012) and dosage of nitroglycerin use(P ＜ 0.01 ) compared to baseline.LVEF [45.0(39.0,48.0) vs.47.0(42.0,50.0) P=0.001],LVEDD[58.0(56.0,59.0) vs.56.0(55.0,58.0) P=0.002],summed perfused score[23.0(20.5,24.5) vs.20.0(18.0,22.0) P＜0.01] and metabolic score[25.0(23.0,26.0) vs.24.0(21.5,25.0) P =0.028] were also improved in CSWT group.All these parameters remained unchanged in control group between baseline and at 1 month. CSWT was independent factor for improved cardiac function,quality of life and echocardiography parameters after adjusting for known factors which might affect outcome.Conclusion CSWT could improve symptom,cardiac function,quality of life and exercise tolerance in patients with ischemic heart failure,CSWT might serve as a new,non-invasive,safe and efficient therapy for these patients.
