The beneficial effect of extracorporeal shockwave myocardial revascularization: Two years of follow-up

Alunni, Gianluca; Barbero, Umberto; Vairo, Alessandro; D'Amico, Salvo; Pianelli, Martina; Zema, Domenica; Bongiovanni, Federica; Gaïta, Fiorenzo

doi:10.1016/j.carrev.2017.05.006

Cited by 11 publications

(6 citation statements)

References 41 publications

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“…The number of studies included involving CCS were 16 [ 11 , 13 , 15 , 16 , 19 , 20 , 24 , 27 - 34 ] , with a total of 819 patients. The included study types were 12 single-arm studies and four cohort studies.…”

Section: Resultsmentioning

confidence: 99%

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%

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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“…A data from both small randomized-controlled trials and real-world experiences confirmed the efficacy of ESMR in terms of symptom improvement, reduced use of short-acting nitrates and hospitalizations, increased myocardial perfusion at different follow-up periods up to 72 months in patients with stable CAD and specifically RA patients [ 66 , 67 , 68 , 69 , 70 , 71 ]. A prospective controlled study of 72 RA patients showed improved symptoms and quality of life parameters, increased myocardial perfusion at six months [ 67 ] with sustained effect at a longer time period (2.88 ± 1.65 years) [ 68 ]. Results of a meta-analysis, including 39 studies, 1006 patients were in line with the previous studies of ESMR, confirming the efficacy and safety of the strategy [ 72 ].…”

Section: Extracorporeal Shockwave Myocardial Revascularizationmentioning

confidence: 84%

Non-pharmacological Treatment of Refractory Angina and Microvascular Angina

Rakhimov

Gori²

2020

Biomedicines

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Refractory angina (RA) is defined as debilitating anginal symptoms despite the optimal guideline-directed combination of medical, percutaneous, and surgical therapies. Often referred to as “no option”, these patients represent a significant unmet clinical need for healthcare institutions. Due to the ageing of the population, and increased survival from coronary artery disease, the number of patients with RA is expected to rise exponentially. Despite the developments of novel technologies for the treatment of RA, none of them found wide clinical application (to date). Microvascular dysfunction, alone or in combination with epicardial coronary disease, is thought to contribute significantly to refractory angina. However, most of the techniques developed to improve RA symptoms have not been tested specifically on patients with microvascular dysfunction. This review discusses the recent developments in the treatment of RA, and gives some perspectives on the future of these techniques.

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“…Improvement in SSS, SDS, ischemic area stress, and ischemic area difference persisted during follow-up, suggesting that there were also long-term effects, possibly related to many different angiogenic pathways, in a manner that may resemble the natural spread of collateral vessels in chronic CAD. 32) Data from an Italian study, which included 72 patients with a maximum follow-up time of 2.88 ± 1.65 years, showed a significant reduction in CCS score, nitroglycerin assumption, and hospitalization rates. 32) A study conducted in China had a follow-up of !…”

Section: Discussionmentioning

confidence: 95%

“…32) Data from an Italian study, which included 72 patients with a maximum follow-up time of 2.88 ± 1.65 years, showed a significant reduction in CCS score, nitroglycerin assumption, and hospitalization rates. 32) A study conducted in China had a follow-up of ! 72 months and showed good results.…”

Section: Discussionmentioning

confidence: 95%

Clinical Outcomes of Cardiac Shockwave Therapy in Severe Coronary Artery Disease Patients after Coronary Artery Bypass Grafting

et al. 2023

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Cardiac shockwave therapy (CSWT) is a noninvasive treatment for patients with refractory angina or myocardial ischemia. This study aims to evaluate the potential beneficial effect and safety of CSWT in patients with severe coronary artery disease (CAD) who have undergone coronary artery bypass grafting (CABG).This was a single-arm prospective cohort study. A total of 30 patients with severe CAD who were not suitable for coronary revascularization and who had undergone CABG were enrolled. All patients received CSWT for nine sessions. Evaluation was performed before and after CSWT, including the Canadian Cardiovascular Society (CCS) classification, New York Heart Association (NYHA) classification, 6-minute walk test (6MWT), Seattle Angina Questionnaire (SAQ) score, nitroglycerin dosage, echocardiography, myocardial perfusion imaging (MPI), and safety parameters. All patients were followed up at both 1 month and 9 months after CSWT.After treatment, CSWT significantly improved CCS classification (P < 0.05), NYHA classification (P < 0.05), nitroglycerin dosage (P < 0.001), and 6MWT (P < 0.05) at 1 month and 9 months after CSWT. SAQ score (P < 0.05) and left ventricular ejection fraction (LVEF; P = 0.037) by echocardiography significantly improved at 1 month after CSWT. Significant decreases in summed stress score (SSS), summed difference score (SDS), ischemic area stress, and ischemic area difference by MPI were observed at 1 month and 9 months after CSWT (P < 0.01). There were no changes in safety parameters before and after CSWT.CSWT may have a beneficial effect on improving myocardial perfusion, clinical symptoms, exertional capacity, and quality of life and is a safe alternative treatment for patients with severe CAD who have undergone CABG.

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The beneficial effect of extracorporeal shockwave myocardial revascularization: Two years of follow-up

Cited by 11 publications

References 41 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

Non-pharmacological Treatment of Refractory Angina and Microvascular Angina

Clinical Outcomes of Cardiac Shockwave Therapy in Severe Coronary Artery Disease Patients after Coronary Artery Bypass Grafting

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