title: Initial clinical experience with extracorporeal shock wave therapy in treatment of ischemic heart failure.
abstract: 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.
authors.affiliation: Department of Functional Methods in Internal Medicine, Moscow State University of Medicine and Dentistry, ul. Delegatskaya 20/1, Moscow, Russian Federation.
authors.forename: Yury A
authors.initials: YA
authors.lastname: Vasyuk
authors.forename: Alla B
authors.initials: AB
authors.lastname: Hadzegova
authors.forename: Evgeny L
authors.initials: EL
authors.lastname: Shkolnik
authors.forename: Maya V
authors.initials: MV
authors.lastname: Kopeleva
authors.forename: Olga V
authors.initials: OV
authors.lastname: Krikunova
authors.forename: Elena N
authors.initials: EN
authors.lastname: Iouchtchouk
authors.forename: Elena M
authors.initials: EM
authors.lastname: Aronova
authors.forename: Svetlana V
authors.initials: SV
authors.lastname: Ivanova
mesh_terms: 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