Journal
CARDIOVASCULAR ULTRASOUND
Volume 17, Issue -, Pages -Publisher
BMC
DOI: 10.1186/s12947-019-0163-1
Keywords
Cardiac shock wave therapy; Coronary artery disease; Stable angina; Myocardial perfusion; Dobutamine stress echocardiography; Single photon emission computed tomography
Categories
Ask authors/readers for more resources
BackgroundRecent triple-blind sham procedure-controlled study revealed neutral effects of the cardiac shock wave therapy (CSWT) on exercise tolerance and symptoms in patients with stable angina. Current data about the effects of CSWT on global and regional myocardial contractility and perfusion is limited. Hereby we report the results of an imaging sub-study that evaluated the capacity of CSWT to ameliorate myocardial ischemia induced during dobutamine stress echocardiography (DSE) and cardiac single photon emission computed tomography (SPECT).MethodsProspective, randomized, triple-blind, sham procedure-controlled study enrolled 72 adult subjects who complied with defined inclusion criteria. The subjects were assigned to the OMT+CSWT and the OMT+sham procedure study groups with 1:1 ratio. Application of the CSWT covered all segments of the left ventricle. Imaging ischemia tests were performed in 59 study patients: DSE and SPECT before the CSWT treatment and after 6months, with DSE carried out additionally at 3months after randomization. Co-primary endpoints of the study were: change in wall motion score index (WMSI), representing the stress-induced impairment of regional myocardial function, and change in summed difference score (SDS), representing the amount of perfusion defect.ResultsOMT+CSWT and OMT+sham procedure study groups included 30 and 29 patients, respectively. Regional myocardial contractility during DSE significantly improved at 3months follow-up in OMT+CSWT group compared to baseline as shown by WMSI at stress (1.40.4 vs 1.60.4, p=0.001), but not in OMT+sham procedure group (1.5 +/- 0.3 vs 1.6 +/- 0.4, p=0.136). The difference in stress DSE results between both study groups disappeared after 6months. SPECT results demonstrated a significant reduction of inducible ischemia in OMT+CSWT group compared to OMT+sham procedure group at 6months follow-up (SDS dropped from 5.4 +/- 3.7 to 3.6 +/- 3.8 vs 6.4 +/- 5.9 to 6.2 +/- 5 respectively, p=0.034).Conclusions Cardiac shock wave treatment showed the ability to reduce stress-induced myocardial ischemia, as assessed by wall motion abnormalities and perfusion defects, compared to sham procedure.Trial registration Clinicaltrials.gov (NCT02339454). The trial was registered retrospectively on 12 January 2015.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available