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Efficacy and safety of cardiac shock wave therapy for patients with severe coronary artery disease: A randomized,
Na Jia1,2, Ruisheng Zhang1, Baoyi Liu1
1Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatrics Medicine, Chinese Academy of Medical Sciences, 1 Dahua Road, Dongdan, Dongcheng, Beijing, 100730, People's Republic of China.
Insights
Cardiac shock wave therapy (CSWT) effectively improved myocardial perfusion in severe coronary artery disease (CAD) patients. While symptoms and quality of life improved, CSWT showed no significant difference compared to controls in these aspects.
Area of Science:
- Cardiology
- Medical Devices
- Regenerative Medicine
Background:
- Coronary artery disease (CAD) poses significant challenges, especially for patients ineligible for reperfusion therapy.
- Cardiac shock wave therapy (CSWT) has shown promise, but robust randomized controlled trials are limited.
- Severe CAD requires exploration of novel therapeutic strategies.
Purpose of the Study:
- To investigate the efficacy and safety of CSWT in patients with severe CAD.
- To evaluate the impact of CSWT on myocardial perfusion and clinical outcomes.
- To compare CSWT with optimal medical treatment in a controlled setting.
Main Methods:
- Thirty patients with severe CAD and evident ischemia on myocardial perfusion imaging (MPI) were enrolled.
- Participants were randomized into CSWT or control groups, receiving optimal medication for at least three months.
- Nine CSWT sessions were administered over three months, with comparisons of clinical symptoms, imaging, and safety parameters.
Main Results:
- CSWT significantly improved regional stress scores and the improvement rate of ischemic areas (P < .001).
- Key myocardial perfusion scores (summed rest, stress, and difference) showed significant improvement in the CSWT group (P < .05).
- While quality of life and exercise capacity improved in both groups, no significant inter-group differences were observed.
Conclusions:
- CSWT is an effective and safe treatment for improving myocardial perfusion in severe CAD patients.
- CSWT demonstrates potential benefits in managing severe coronary artery disease.
- Further research is warranted to fully elucidate the long-term clinical impact of CSWT.
Background:
Previous studies proved the efficacy of cardiac shock wave therapy (CSWT) for coronary artery disease (CAD) patients who are not candidate for reperfusion therapy. Randomized control trials are limited. We try to explore the efficacy and safety of CSWT for patients with severe CAD.
Methods:
Thirty patients with severe CAD who had obvious ischemia on myocardial perfusion imaging (MPI) were enrolled and randomly assigned to the CSWT group or the control group. They had received optimal medication treatment for at least three months. Nine sessions of shock wave therapy were conducted over 3 months. CSWT group received the real treatment, while the control group received the pseudo-treatment. Clinical symptom, imaging outcomes and safety parameters were compared between two groups.
Results:
After treatment, regional stress score (P = .023), improvement rate (IR) of ischemic area (IA) stress (P < .001) and IR of IA difference (P < .001) were significantly favor CSWT group. The interaction of summed rest score (P < .001), summed stress score (P = .004), summed difference score (P = .036) were significantly improved in the CSWT group compared to the control group. Seattle angina questionnaire, quality of life (QOL) and the distance of six-minute walking test (6MWT) were improved in both groups without significant difference between them. Hemodynamic parameters were stable during procedure. Myocardial injury markers showed no changes in two groups.
Conclusions:
Our study demonstrated CSWT could effectively and safely improve myocardial perfusion in patients with severe CAD. Clinical symptom, QOL and 6MWT were all improved after treatment, but no significant difference between two groups.
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