title: [Effects of extracorporeal cardiac shock wave therapy in patients with ischemic heart failure].
abstract: OBJECTIVE
  To evaluate the feasibility, safety and efficiency of extracorporeal cardiac shock wave therapy (CSWT) in patients with ischemic heart failure.
  
  
  METHODS
  Fifty patients with ischemic heart failure and left ventricular ejection fraction (LVEF) < 50% were randomized to CSWT (shots/spot at 0.09 mJ/mm(2) for 9 spots, 9 times within 3 month) or control group. Dual isotope simultaneous acquisition single-photon emission computed tomography with (99)Tc(m)-sestamibi/(18)F-fluorodeoxyglucose ((99)Tc(m)-MIBI/(18)F-FDG) was performed before randomization and at 1 month after CSWT/control to locate and evaluate viable myocardium region. Canadian cardiovascular society (CCS) class sores, NYHA, Seattle Angina Questionnaire (SAQ), 6-min walk test (6 MWT), left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension (LVEDD) and the dosage of nitroglycerin use were compared between two groups at each time point.
  
  
  RESULTS
  All patients completed the study protocol without procedural complications. At 1 month, patients in CSWT group experienced improvement in NYHA (P < 0.01), CCS (P < 0.01), SAQ (P = 0.021), 6 MWT (P = 0.012) and dosage of nitroglycerin use (P < 0.01) compared to baseline. LVEF [45.0 (39.0, 48.0) vs. 47.0 (42.0, 50.0) P = 0.001], LVEDD [58.0 (56.0, 59.0) vs. 56.0 (55.0, 58.0) P = 0.002], summed perfused score [23.0 (20.5, 24.5) vs. 20.0 (18.0, 22.0) P < 0.01] and metabolic score [25.0 (23.0, 26.0) vs. 24.0 (21.5, 25.0) P = 0.028] were also improved in CSWT group. All these parameters remained unchanged in control group between baseline and at 1 month. CSWT was independent factor for improved cardiac function, quality of life and echocardiography parameters after adjusting for known factors which might affect outcome.
  
  
  CONCLUSIONS
  CSWT could improve symptom, cardiac function, quality of life and exercise tolerance in patients with ischemic heart failure, CSWT might serve as a new, non-invasive, safe and efficient therapy for these patients.
authors.affiliation: Department of Cardiology, Kunming Medical College, Kunming, China.
authors.forename: Yun-zhu
authors.initials: YZ
authors.lastname: Peng
authors.forename: Tao
authors.initials: T
authors.lastname: Guo
authors.forename: Ping
authors.initials: P
authors.lastname: Yang
authors.forename: Hong-wen
authors.initials: HW
authors.lastname: Yang
authors.forename: Ping
authors.initials: P
authors.lastname: Zhou
authors.forename: Yu
authors.initials: Y
authors.lastname: Wang
authors.forename: Zhi-ling
authors.initials: ZL
authors.lastname: Luo
authors.forename: Yun
authors.initials: Y
authors.lastname: Gu
authors.forename: Jia-hua
authors.initials: JH
authors.lastname: Pan
mesh_terms: D000368:Aged; D004554:Electric Countershock; D005260:Female; D006333:Heart Failure / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D013318:Stroke Volume; D016896:Treatment Outcome