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Role of Ultrasound-Based Therapies in Cardiovascular Diseases
Amit Bansal1,2, Bernard Bulwer3, Ricarda von Krüchten4,5
1Bergen COVID-19 Research group and Influenza Centre, Department of Clinical Science, University of Bergen, Bergen, Norway.
Insights
Therapeutic ultrasound offers innovative treatments for cardiovascular diseases (CVDs). High-intensity focused ultrasound, extracorporeal shock wave therapy, and low-intensity pulsed ultrasound show promise for managing complex CVD cases.
Area of Science:
- Cardiology
- Biomedical Engineering
- Medical Physics
Background:
- Cardiovascular diseases (CVDs) are a leading global cause of death and healthcare expenditure.
- Current CVD management strategies face limitations, necessitating novel therapeutic approaches.
- Ultrasound-based therapies are emerging as a promising innovative strategy for CVD management.
Purpose of the Study:
- To explore three distinct ultrasound-based therapeutic modalities for cardiovascular diseases.
- To review the mechanisms of action and therapeutic outcomes of each modality.
- To assess the potential of these therapies as adjuncts in managing challenging CVD cases.
Main Methods:
- Review of high-intensity focused ultrasound (HIFU) applications in myocardial infarction, arrhythmias, hypertension, and other cardiovascular conditions.
- Evaluation of extracorporeal shock wave therapy (ESWT) for chronic refractory angina pectoris.
- Analysis of low-intensity pulsed ultrasound (LIPUS) for dissolving blood clots and improving blood flow in pulmonary embolism.
Main Results:
- HIFU demonstrates benefits as an adjunct for myocardial infarction, arrhythmias, and has been investigated for hypertension, aortic stenosis, and hypertrophic cardiomyopathy.
- ESWT shows efficacy in treating chronic refractory angina pectoris.
- LIPUS is beneficial for dissolving blood clots and improving blood flow in pulmonary embolism, with a noted increased risk of bleeding.
Conclusions:
- Ultrasound-based therapies, including HIFU, ESWT, and LIPUS, represent potential adjuncts for managing complex cardiovascular diseases.
- These therapies offer comparatively safe options for challenging CVD cases.
- Further research is crucial to validate the long-term effectiveness and safety of ultrasound therapies, especially in high-risk populations.
Abstract:
Cardiovascular diseases (CVDs) remain the leading cause of morbidity and mortality globally, placing an immense burden on health care costs worldwide. The emergence of therapeutic ultrasound-based therapies in the CVD management represents a promising innovative strategy beyond current established approaches. This paper explores three distinct modalities of ultrasound-based therapies-high-intensity focused ultrasound, extracorporeal shock wave therapy, and low-intensity pulsed ultrasound-each characterized by unique acoustic parameters and mechanisms of action tailored to specific therapeutic outcomes. High-intensity focused ultrasound was shown to be beneficial as an adjunct in the treatment of myocardial infarction and arrhythmias. It has also been investigated for the in vivo treatment of resistant hypertension, symptomatic aortic valve stenosis, arterial stenosis, tumors, hypertrophic cardiomyopathy, and external cardiac pacing. Extracorporeal shock wave therapy was shown to be beneficial in the treatment of chronic refractory angina pectoris, while low-intensity pulsed ultrasound was shown to be beneficial in dissolving blood clots and improving blood flow in the treatment of acute pulmonary embolism, despite its association with an increased risk of bleeding. Ultrasound-based therapies are, therefore, a potential adjunct and comparatively safe adjuncts for managing challenging CVD cases. Further investigations are essential to validate their long-term effectiveness and safety, particularly for high-risk individuals susceptible to postprocedural complications.
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