Abstract 14516: Extracorporeal Cardiac Shock Wave Therapy Improved Perfusion and Cardiac Function of Patients With Ischemic Heart Failure
Objective: Extracorporeal cardiac shock wave therapy (CSWT) has been proved as a new, noninvasive, angiogenesis-based option in patients with refractory angina pectoris. This study aimed to explore the effect of CSWT on prognosis of patients with ischemic heart failure (IHF).
Methods: Patients (pts) with IHF (LVEF<50%) were randomized to CSWT group (200 shots/spot at 0.09 mJ/mm2 * 9 spots * 9 times in 3 months) or control group (same procedures w/o shock wave energy). Dual isotope simultaneous acquisition SPECT with 99m Tc-M IBI / 18 F-FDG was performed to locate and evaluate viable region. CCS, NYHA classification, Seattle Angina Questionnaire(SAQ), 6-min walk test(6MWT) , LVEF, LVEDD, base and strain peak systolic strain rate(PSSR) measured by echocardiography, and plasma BNP were compared between 2 groups at baseline and 3 months after CSWT.
Results: Fifty pts (35 were men, 70%)were enrolled between 2009-2011 with mean age of 66.3±7.2. All pts completed the study without adverse event. Baseline characteristics were comparable between CSWT (n=25) and control group (n=25). At 3 months after CSWT, summed perfusion and metabolism score, base and strain PSSR, NYHA classification and 6MWT improved in CSWT group compared to baseline and pts in control group. While improved SAQ (59.0±9.4 vs. 66.9±11.2, P=0.03) and LVEF (%) (45.0±6.4 vs. 48.7±10.5, P=0.02), decreased LVEDD (63.1±11.4 vs. 58.1±4.0mm, P=0.03) and BNP (pg/ml) (1702.3±122.8 vs. 1334.8±227.9, P=0.001) were observed in CSWT but control group.
Conclusion: CSWT improved the perfusion and metabolism of viable myocardium as well as the symptom, cardiac function, quality of life and exercise tolerance in IHF pts. It could be considered as a new, non-invasive for these pts.
Figure: Comparison between CSWT and control group at different time point. A: Base and strain PSSR in Dubutamin stress echocardiography; B: Summed perfusion and metabolism score in SPECT; C: 6 minute walk test; D: NYHA classification.
- © 2013 by American Heart Association, Inc.