Initial clinical experience with extracorporeal shock wave therapy in treatment of ischemic heart failure.
Previous experimental studies have suggested a beneficial effect of extracorporeal shock wave therapy (ESWT) in patients with ischemic heart failure. Twenty-four patients with ischemic heart failure and left ventricular ejection fraction (LVEF) <40% received ESWT in addition to their stable treatment. ESWT was performed in 9 sessions with 100 shocks per spot in viable segments detected by dobutamine stress echocardiography. Patients were evaluated at baseline and at 3 and 6 months after ESWT. Tc-99m MIBI single photon emission computed tomography was performed on inclusion and at 6 months. ESWT significantly decreased New York Heart Association class from 2.2±0.8 to 1.7±0.7 at 3 months (P<.01) and 6 months after ESWT (1.7±0.7). Six-minute walk test improved from 414±141 to 509±141 and 538±116 (P<.01) at 3 and 6 months, respectively. A steady decrease of Canadian Cardiovascular Society angina class from 2.6±0.7 to 2.1±0.8 and 1.9±0.7 (P<.01) at 3 and 6 months, respectively, was observed. A significant increase in LVEF at rest at 3 and 6 months after ESWT (from 32.2±6.0 to 34.8±9.6 and 37.7±9.5, P=.03, respectively) was noted. Summed rest score (from 23.9±8.1 to 21.4±7.1, P=.03) and stress score improvement (from 28.2±8.4 to 24.6±6.4, P=.04) by single photon emission computed tomography was registered. Significant clinical improvement accompanied by beneficial changes of LVEF and rest/stress perfusion was found after ESWT.
Vasyuk
Yury A
YA
Department of Functional Methods in Internal Medicine, Moscow State University of Medicine and Dentistry, ul. Delegatskaya 20/1, Moscow, Russian Federation.
Hadzegova
Alla B
AB
Shkolnik
Evgeny L
EL
Kopeleva
Maya V
MV
Krikunova
Olga V
OV
Iouchtchouk
Elena N
EN
Aronova
Elena M
EM
Ivanova
Svetlana V
SV
D025401:Echocardiography, Stress; D005080:Exercise Test; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D017202:Myocardial Ischemia / Q000150:complications / Q000503:physiopathology; D010147:Pain Measurement; D012720:Severity of Illness Index; D012780:Short-Wave Therapy; D013318:Stroke Volume; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome