A randomized, triple-blind trial of cardiac shock-wave therapy on exercise tolerance and symptoms in patients with stable angina pectoris

Shkolnik, Evgeny; Burneikaitė, Greta; Jakutis, Gabrielius; Scherbak, Mikhail; Zuozienė, Gitana; Petrauskienė, Birutė; Trush, E.Yu.; Vasyuk, Yu. A.; Laucevičius, Aleksandras; Čelutkienė, Jelena

doi:10.1097/mca.0000000000000648

Cited by 16 publications

(13 citation statements)

References 21 publications

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“…This study included 26 clinical studies [ 5 - 7 , 9 - 34 ] and a total of 855 patients with CAD, including 781 patients treated with CSWT and 74 patients receiving drug treatment. This study included the follow-up time span from the literature.…”

Section: Resultsmentioning

confidence: 99%

“…The number of studies included involving exercise test were five [ 5 , 6 , 11 , 16 , 24 ] , with a total of 484 patients. The included study types were two single-arm studies, two cohort studies, and one RCT.…”

Section: Resultsmentioning

confidence: 99%

“…In the existing study, the clinical prognosis evaluation differs greatly due to the small sample size of the general clinical study. Evgeny et al [ 5 ] conducted a randomized controlled trial (RCT) of 72 patients and assessed exercise tolerance and found no significant differences between the two groups. Prior to this, the reports of improvement in exercise tolerance in the study by Prasad et al [ 6 ] and Cassar et al [ 7 ] were significant.…”

Section: Introductionmentioning

confidence: 99%

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Cardiac Shock Wave Therapy for Coronary Heart Disease: an Updated Meta-analysis

Huang¹,

Xie²,

Hou³

et al. 2020

Braz J Cardiovasc Surg

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Introduction The aim of this article is to study the efficacy and safety of cardiac shock wave therapy (CSWT) in the treatment of coronary heart disease (CAD). Methods A comprehensive search of electronic databases and a manual search of conference papers and abstracts were performed until September 30, 2018. The studies using RevMan 5.3 and STATA 14.0 softwares were reviewed, and meta-analyses were performed on 13 indicators, such as a six-min walking distance test (6MWT), New York Heart Association (NYHA) functional class, Seattle Angina Questionnaire (SAQ) score, angina class (Canadian Cardiology Society [CCS]), etc. Results A total of 26 articles were included. The total patient population was 855, of which 781 patients were treated with CSWT. Meta-analyses indicated that 6MWT (mean difference [MD] 75.64, 95% confidence interval [CI] 49.03, 102.25, P <0.00001) and NYHA (MD -0.70, 95% CI -0.92) in the CSWT group were comparable to those in the conventional revascularization group (MD -0.70, 95% CI -0.92, -0.49, P <0.00001). SAQ (MD 10.75, 95% CI 6.66, 14.83, P <0.00001), CCS (MD -0.99, 95% CI -1.13, -0.84, P <0.00001), nitrate dosage (MD -1.84, 95% CI -2.77, -1.12, P <0.00001), LVEF (MD 3.77, 95% CI 2.17, 5.37, P <0.00001), and SSS (MD -4.29, 95% CI -5.61, -2.96, P <0.00001), SRS (MD -2.90, 95% CI -4.85, -0.95, P =0.004), and the exercise test (standard mean difference 0.57, 95% CI 0.12, 1.02, P =0.01) all showed significant differences. Conclusion CSWT may offer beneficial effects to patients with CAD, but more large-scale clinical studies are needed to further verify its therapeutic effect.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cardiac Shock Wave Therapy for Coronary Heart Disease: an Updated Meta-analysis

Huang¹,

Xie²,

Hou³

et al. 2020

Braz J Cardiovasc Surg

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“…Moreover, only limited information about the effects of CSWT on global and regional myocardial contractility and perfusion is available in current literature. In addition to the prospective, randomized, triple blind, sham-procedure controlled trial [16], we performed an imaging sub-study to evaluate the capacity of CSWT to reduce the objective signs of myocardial ischemia, that were determined by dobutamine stress echocardiography (DSE) and SPECT.…”

Section: Introductionmentioning

confidence: 99%

The effect of cardiac shock wave therapy on myocardial function and perfusion in the randomized, triple-blind, sham-procedure controlled study

Čelutkienė

Burneikaitė

Shkolnik

et al. 2019

Cardiovasc Ultrasound

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Background Recent 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). Methods Prospective, 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 6 months, with DSE carried out additionally at 3 months 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. Results OMT + CSWT and OMT + sham procedure study groups included 30 and 29 patients, respectively. Regional myocardial contractility during DSE significantly improved at 3 months follow-up in OMT + CSWT group compared to baseline as shown by WMSI at stress (1.4 ± 0.4 vs 1.6 ± 0.4, 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 6 months. SPECT results demonstrated a significant reduction of inducible ischemia in OMT + CSWT group compared to OMT + sham procedure group at 6 months 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.

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“…Было показано, что присоединение УВТ к стандартной медикаментозной терапии значительно уменьшило количество приступов стенокардии и снизило потребность в применении нитратов. Оценка результатов проведения нагрузочных проб, показала достоверное повышение ТФН на фоне лечения [8].…”

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Various protocols of extracorporeal shock wave therapy in the treatment of stable angina

Щербак

Shkolnik

Васюк

et al. 2019

Cardiovasc Ther Prev

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Институт клинической медицины, клиника сердечно-сосудистых заболеваний. Вильнюс, Литва Цель. Оценить качество жизни и толерантность к физической нагрузке на фоне различных протоколов ударно-волновой терапии (УВТ) сердца у больных стабильной стенокардии на фоне оптимальной медикаментозной терапии (ОМТ). Материал и методы. В исследование включены 53 пациента (37 мужчин, 16 женщин). Средний возраст обследованных пациентов составил 67,3±8,1 лет. Критерии включения: стенокардия I-IV функциональных классов (ФК) на фоне адекватной стабильной медикаментозной терапии в течение минимум 1 мес. до включения в исследования и стабильное течение ишемической болезни сердца >3 мес. (отсутствие сердечно-сосудистых событий) до включения в исследование. Пациенты были распределены на две группы. Первая группа (n=37) получала ОМТ+УВТ по стандартному протоколу, вторая группа (n=16) получала ОМТ+УВТ по ускоренному протоколу. Электрокардиография, эхокардиография, тредмил-тест, Сиэтлский опросник качества жизни (SAQ) проводились при включении и через 6 мес. наблюдения. Результаты. На фоне проведения УВТ по ускоренному и стандартному протоколу к 6 мес. наблюдения достоверно снизилось количество принимаемых нитратов короткого действия: с 2 (2; 7) до 1 (0; 2) (p=0,04) и с 2 (0; 6) до 0 (0; 2) (p≤0,001), соответственно, а также количество приступов стенокардии в нед.: с 4 (2; 7) до 1 (1; 1) (p=0,007) и 6 (2; 20) до 1 (0;5) (p≤0,001). При анализе результатов тредмил-теста, достоверно увеличилось общее время продолжи-тельности нагрузки с 393 (326; 574) до 561 (411; 650) сек (p=0,007) и 365±140,4 до 411,5±156,1 сек (p=0,01), соответственно. Достоверно увеличилось время нагрузки до появления депрессии сегмента ST c 399,8±169 до 460±182 сек (p≤0,05) и с 303,1±179 до 389,9±203 сек (p=0,001), соответственно. Заключение. По результатам проведенного исследования УВТ серд ца по ускоренному универсальному протоколу улучшает качество жизни и толерантность к физической нагрузке у больных стабильной стенокардией в степени, сопоставимой со стандартным протоколом по данным ранее проведенных исследований. При этом УВТ по ускоренному универсальному протоколу уменьшает общую длительность лечения и делает методику более доступной для широкого применения. Ключевые слова: ишемическая болезнь сердца, стабильная стенокардия, экстракорпоральная ударно-волновая терапия сердца. Конфликт интересов: не заявлен.

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A randomized, triple-blind trial of cardiac shock-wave therapy on exercise tolerance and symptoms in patients with stable angina pectoris

Abstract: The total exercise duration in the modified Bruce treadmill test at the 6-month follow-up did not differ significantly in patients treated with CSWT compared with optimal medical therapy alone. In addition, CSWT exerted a neutral effect on the quality of life and level of angina.

Cited by 16 publications

References 21 publications

Cardiac Shock Wave Therapy for Coronary Heart Disease: an Updated Meta-analysis

Cardiac Shock Wave Therapy for Coronary Heart Disease: an Updated Meta-analysis

The effect of cardiac shock wave therapy on myocardial function and perfusion in the randomized, triple-blind, sham-procedure controlled study

Various protocols of extracorporeal shock wave therapy in the treatment of stable angina

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