Skip to main content
Top
Published in: Cardiovascular Ultrasound 1/2012

Open Access 01-12-2012 | Research

A modified regimen of extracorporeal cardiac shock wave therapy for treatment of coronary artery disease

Authors: Yu Wang, Tao Guo, Tie-kun Ma, Hong-yan Cai, Si-ming Tao, Yun-zhu Peng, Ping Yang, Ming-qing Chen, Yun Gu

Published in: Cardiovascular Ultrasound | Issue 1/2012

Login to get access

Abstract

Background

Cardiac shock wave therapy (CSWT) improves cardiac function in patients with severe coronary artery disease (CAD). We aimed to evaluate the clinical outcomes of a new CSWT treatment regimen.

Methods

The 55 patients with severe CAD were randomly divided into 3 treatment groups. The control group (n = 14) received only medical therapy. In group A ( n = 20), CSWT was performed 3 times within 3 months. In group B ( n = 21), patients underwent 3 CSWT sessions/week, and 9 treatment sessions were completed within 1 month. Primary outcome measurement was 6-minute walk test (6MWT). Other measurements were also evaluated.

Results

The 6MWT, CCS grading of angina, dosage of nitroglycerin, NYHA classification, and SAQ scores were improved in group A and B compared to control group.

Conclusions

A CSWT protocol with 1 month treatment duration showed similar therapeutic efficacy compared to a protocol of 3 months duration.

Clinical trial registry

We have registered on ClinicalTrials.gov, the protocol ID is CSWT IN CHINA.
Appendix
Available only for authorised users
Literature
1.
2.
go back to reference Rihal CS, Raco DL, Gersh BJ, Yusuf S: Indications for coronary artery bypass surgery and percutaneous coronary intervention in chronic stable angina: review of the evidence and methodological considerations. Circulation. 2003, 108: 2439-2445. 10.1161/01.CIR.0000094405.21583.7CCrossRefPubMed Rihal CS, Raco DL, Gersh BJ, Yusuf S: Indications for coronary artery bypass surgery and percutaneous coronary intervention in chronic stable angina: review of the evidence and methodological considerations. Circulation. 2003, 108: 2439-2445. 10.1161/01.CIR.0000094405.21583.7CCrossRefPubMed
3.
go back to reference Rassweiler JJ, Knoll T, Köhrmann KU, et al.: Shock wave technology and application: an update. Eur Urol. 2011, 59: 784-796. 10.1016/j.eururo.2011.02.033CrossRefPubMedPubMedCentral Rassweiler JJ, Knoll T, Köhrmann KU, et al.: Shock wave technology and application: an update. Eur Urol. 2011, 59: 784-796. 10.1016/j.eururo.2011.02.033CrossRefPubMedPubMedCentral
4.
go back to reference Zelle BA, Gollwitzer H, Zlowodzki M, Bühren V: Extracorporeal shock wave therapy: current evidence. J Orthop Trauma. 2010, 24 (Suppl 1): S66-S70.CrossRefPubMed Zelle BA, Gollwitzer H, Zlowodzki M, Bühren V: Extracorporeal shock wave therapy: current evidence. J Orthop Trauma. 2010, 24 (Suppl 1): S66-S70.CrossRefPubMed
5.
go back to reference Nishida T, Shimokawa H, Oi K, et al.: Extracorporeal cardiac shock wave therapy markedly ameliorates ischemia-induced myocardial dysfunction in pigs in vivo. Circulation. 2004, 110: 3055-3061. 10.1161/01.CIR.0000148849.51177.97CrossRefPubMed Nishida T, Shimokawa H, Oi K, et al.: Extracorporeal cardiac shock wave therapy markedly ameliorates ischemia-induced myocardial dysfunction in pigs in vivo. Circulation. 2004, 110: 3055-3061. 10.1161/01.CIR.0000148849.51177.97CrossRefPubMed
6.
go back to reference Uwatoku T, Ito K, Abe K, Hizume T, Sunagawa K, Shimokawa H: Extracorporeal cardiac shock wave therapy proves left ventricular remodeling after acute myocardial infarction in pigs. Coron Artery Dis. 2007, 18: 397-404. 10.1097/MCA.0b013e328089f19bCrossRefPubMed Uwatoku T, Ito K, Abe K, Hizume T, Sunagawa K, Shimokawa H: Extracorporeal cardiac shock wave therapy proves left ventricular remodeling after acute myocardial infarction in pigs. Coron Artery Dis. 2007, 18: 397-404. 10.1097/MCA.0b013e328089f19bCrossRefPubMed
7.
go back to reference Ito K, Fukumoto Y, Shimokawa H: Extracorporeal shock wave therapy as a new and non-invasive angiogenic strategy. Tohoku J Exp Med. 2009, 219: 1-9. 10.1620/tjem.219.1CrossRefPubMed Ito K, Fukumoto Y, Shimokawa H: Extracorporeal shock wave therapy as a new and non-invasive angiogenic strategy. Tohoku J Exp Med. 2009, 219: 1-9. 10.1620/tjem.219.1CrossRefPubMed
8.
go back to reference Kikuchi Y, Ito K, Ito Y, et al.: Double-blind and placebo-controlled study of the effectiveness and safety of extracorporeal cardiac shock wave therapy for severe angina pectoris. Circ J. 2010, 74: 589-591. 10.1253/circj.CJ-09-1028CrossRefPubMed Kikuchi Y, Ito K, Ito Y, et al.: Double-blind and placebo-controlled study of the effectiveness and safety of extracorporeal cardiac shock wave therapy for severe angina pectoris. Circ J. 2010, 74: 589-591. 10.1253/circj.CJ-09-1028CrossRefPubMed
9.
go back to reference Vasyuk YA, Hadzegova AB, Shkolnik EL, et al.: Initial clinical experience with extracorporeal shock wave therapy in treatment of ischemic heart failure. Congest Heart Fail. 2010, 16: 226-230. 10.1111/j.1751-7133.2010.00182.xCrossRefPubMed Vasyuk YA, Hadzegova AB, Shkolnik EL, et al.: Initial clinical experience with extracorporeal shock wave therapy in treatment of ischemic heart failure. Congest Heart Fail. 2010, 16: 226-230. 10.1111/j.1751-7133.2010.00182.xCrossRefPubMed
10.
go back to reference Khattab AA, Brodersen B, Schuermann-Kuchenbrandt D, et al.: Extracorporeal cardiac shock wave therapy: first experience in the everyday practice for treatment of chronic refractory angina pectoris. Int J Cardiol. 2007, 121: 84-85. 10.1016/j.ijcard.2006.08.030CrossRefPubMed Khattab AA, Brodersen B, Schuermann-Kuchenbrandt D, et al.: Extracorporeal cardiac shock wave therapy: first experience in the everyday practice for treatment of chronic refractory angina pectoris. Int J Cardiol. 2007, 121: 84-85. 10.1016/j.ijcard.2006.08.030CrossRefPubMed
11.
go back to reference Fukumoto Y, Ito A, Uwatoku T, et al.: Extracorporeal cardiac shock wave therapy ameliorates myocardial ischemia in patients with severe coronary artery disease. Coron Artery Dis. 2006, 17: 63-70. 10.1097/00019501-200602000-00011CrossRefPubMed Fukumoto Y, Ito A, Uwatoku T, et al.: Extracorporeal cardiac shock wave therapy ameliorates myocardial ischemia in patients with severe coronary artery disease. Coron Artery Dis. 2006, 17: 63-70. 10.1097/00019501-200602000-00011CrossRefPubMed
12.
go back to reference Wang Y, Guo T, Cai HY, et al.: Cardiac shock wave therapy reduces angina and improves myocardial function in patients with refractory coronary artery disease. Clin Cardiol. 2010, 33: 693-699. 10.1002/clc.20811CrossRefPubMed Wang Y, Guo T, Cai HY, et al.: Cardiac shock wave therapy reduces angina and improves myocardial function in patients with refractory coronary artery disease. Clin Cardiol. 2010, 33: 693-699. 10.1002/clc.20811CrossRefPubMed
13.
go back to reference Wang Y, Guo T, Cai H, et al.: Extracorporeal cardiac shock wave therapy for treatment of coronary artery disease. Chin J Cardiol. Article in Chinese, 2010, 38: 711-715. Wang Y, Guo T, Cai H, et al.: Extracorporeal cardiac shock wave therapy for treatment of coronary artery disease. Chin J Cardiol. Article in Chinese, 2010, 38: 711-715.
14.
go back to reference Prinz C, Lindner O, Bitter T, et al.: Extracorporeal cardiac shock wave therapy ameliorates clinical symptoms and improves regional myocardial blood flow in a patient with severe coronary artery disease and refractory angina. Case Report Med. 2009, 2009: 639594- Prinz C, Lindner O, Bitter T, et al.: Extracorporeal cardiac shock wave therapy ameliorates clinical symptoms and improves regional myocardial blood flow in a patient with severe coronary artery disease and refractory angina. Case Report Med. 2009, 2009: 639594-
15.
go back to reference Shimokawa H, Ito K, Fukumoto Y, Yasuda S: Extracorporeal cardiac shock wave therapy for ischemic heart disease. Shock Waves. 2008, 17: 449-455. 10.1007/s00193-008-0122-5.CrossRef Shimokawa H, Ito K, Fukumoto Y, Yasuda S: Extracorporeal cardiac shock wave therapy for ischemic heart disease. Shock Waves. 2008, 17: 449-455. 10.1007/s00193-008-0122-5.CrossRef
16.
go back to reference Chinese Society of Cardiology of Chinese Medical Association, Editorial Board of Chinese Journal of Cardiology: Guideline for diagnosis and treatment of patients with unstable angina and non- ST-segment elevation myocardial infarction. Chin J Cardiol. Article in Chinese, 2007, 35: 295-304. Chinese Society of Cardiology of Chinese Medical Association, Editorial Board of Chinese Journal of Cardiology: Guideline for diagnosis and treatment of patients with unstable angina and non- ST-segment elevation myocardial infarction. Chin J Cardiol. Article in Chinese, 2007, 35: 295-304.
17.
go back to reference Zweng A, Bachl C, Schragel D, Veegh W, Schneider B, Stöllberger C: The role of dobutamine stress echocardiography in the clinical routine of a department of cardiology. Acta Med Austriaca. Article in German, 2002, 8: 123-128. Zweng A, Bachl C, Schragel D, Veegh W, Schneider B, Stöllberger C: The role of dobutamine stress echocardiography in the clinical routine of a department of cardiology. Acta Med Austriaca. Article in German, 2002, 8: 123-128.
18.
go back to reference San Román JA, Sanz Ruiz R, Ortega JR, et al.: Safety and predictors of complications with a new accelerated Dobutamine stress echocardiography protocol. J Am Soc Echocardiogr. 2008, 21: 53-57. 10.1016/j.echo.2007.05.025CrossRefPubMed San Román JA, Sanz Ruiz R, Ortega JR, et al.: Safety and predictors of complications with a new accelerated Dobutamine stress echocardiography protocol. J Am Soc Echocardiogr. 2008, 21: 53-57. 10.1016/j.echo.2007.05.025CrossRefPubMed
19.
go back to reference Armstrong G, Pasquet A, Fukamachi K, Cardon L, Olstad B, Marwick T: Use of peak systolic strain as index of regional left ventricular function: comparison with tissue Doppler velocity during Dobutamine stress and myocardial ischemia. J Am Soc Echocardiogr. 2000, 13: 731-737. 10.1067/mje.2000.105912CrossRefPubMed Armstrong G, Pasquet A, Fukamachi K, Cardon L, Olstad B, Marwick T: Use of peak systolic strain as index of regional left ventricular function: comparison with tissue Doppler velocity during Dobutamine stress and myocardial ischemia. J Am Soc Echocardiogr. 2000, 13: 731-737. 10.1067/mje.2000.105912CrossRefPubMed
20.
go back to reference Deng YB, Liu R, Wu YH, Xiong L, Liu YN: Evaluation of short-axis and long-axis myocardial function with two-dimensional strain echocardiography in patients with different degrees of coronary artery stenosis. Ultrasound Med Biol. 2010, 36: 227-233. 10.1016/j.ultrasmedbio.2009.09.012CrossRefPubMed Deng YB, Liu R, Wu YH, Xiong L, Liu YN: Evaluation of short-axis and long-axis myocardial function with two-dimensional strain echocardiography in patients with different degrees of coronary artery stenosis. Ultrasound Med Biol. 2010, 36: 227-233. 10.1016/j.ultrasmedbio.2009.09.012CrossRefPubMed
21.
go back to reference Cerqueira MD, Weissman NJ, Dilsizian V, et al.: Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart: a statement for healthcare professionals from the Cardiac Imaging Committee Of the Council on Clinical Cardiology of the American Heart Association. J Nucl Cardiol. 2002, 9: 240-245. 10.1067/mnc.2002.123122CrossRefPubMed Cerqueira MD, Weissman NJ, Dilsizian V, et al.: Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart: a statement for healthcare professionals from the Cardiac Imaging Committee Of the Council on Clinical Cardiology of the American Heart Association. J Nucl Cardiol. 2002, 9: 240-245. 10.1067/mnc.2002.123122CrossRefPubMed
22.
go back to reference Mandalapu BP, Amato M, Stratmann HG: Technetium Tc 99 m sestamibi myocardial perfusion imaging: current role for evaluation of prognosis. Chest. 1999, 115: 1684-1694. 10.1378/chest.115.6.1684CrossRefPubMed Mandalapu BP, Amato M, Stratmann HG: Technetium Tc 99 m sestamibi myocardial perfusion imaging: current role for evaluation of prognosis. Chest. 1999, 115: 1684-1694. 10.1378/chest.115.6.1684CrossRefPubMed
23.
go back to reference Kim C, Kwok YS, Heagerty P, Redberg R: Pharmacologic stress testing for coronary disease diagnosis: A meta-analysis. Am Heart J. 2001, 142: 934-944. 10.1067/mhj.2001.119761CrossRefPubMed Kim C, Kwok YS, Heagerty P, Redberg R: Pharmacologic stress testing for coronary disease diagnosis: A meta-analysis. Am Heart J. 2001, 142: 934-944. 10.1067/mhj.2001.119761CrossRefPubMed
24.
go back to reference Spertus JA, Winders JA, Dewhurst TA, et al.: Development and evaluation of the Seattle Angina Questionnaire: a new functional status measure for coronary artery disease. J Am Coll Cardiol. 1995, 25: 333-341. 10.1016/0735-1097(94)00397-9CrossRefPubMed Spertus JA, Winders JA, Dewhurst TA, et al.: Development and evaluation of the Seattle Angina Questionnaire: a new functional status measure for coronary artery disease. J Am Coll Cardiol. 1995, 25: 333-341. 10.1016/0735-1097(94)00397-9CrossRefPubMed
25.
go back to reference Voight J-U, Exner B, Schmiedehausen K, et al.: Strain-rate imaging during dobutamine stress echocardiography provides objective evidence of inducible ischemia. Circulation. 2003, 107: 2120-2126. 10.1161/01.CIR.0000065249.69988.AACrossRef Voight J-U, Exner B, Schmiedehausen K, et al.: Strain-rate imaging during dobutamine stress echocardiography provides objective evidence of inducible ischemia. Circulation. 2003, 107: 2120-2126. 10.1161/01.CIR.0000065249.69988.AACrossRef
26.
go back to reference Voight J-U, Nixdorff U, Bogdan R, et al.: Comparison of deformation imaging and velocity imaging for detecting regional inducible ischaemia during dobutamine s tress echocardiography. Eur Heart J. 2004, 25: 1517-1525. 10.1016/j.ehj.2004.05.014CrossRef Voight J-U, Nixdorff U, Bogdan R, et al.: Comparison of deformation imaging and velocity imaging for detecting regional inducible ischaemia during dobutamine s tress echocardiography. Eur Heart J. 2004, 25: 1517-1525. 10.1016/j.ehj.2004.05.014CrossRef
27.
go back to reference Mariotto S, Cavalieri E, Amelio E, et al.: Extracorporeal shock waves: from lithotripsy to anti-inflammatory action by NO production. Nitric Oxide. 2005, 12: 89-96. 10.1016/j.niox.2004.12.005CrossRefPubMed Mariotto S, Cavalieri E, Amelio E, et al.: Extracorporeal shock waves: from lithotripsy to anti-inflammatory action by NO production. Nitric Oxide. 2005, 12: 89-96. 10.1016/j.niox.2004.12.005CrossRefPubMed
28.
go back to reference Wang FS, Wang CJ, Huang HJ, Chung H, Chen RF, Yang KD: Physical shock wave mediates membrane hyperpolarization and Ras activation for osteogenesis in human bone marrow stromal cells. Biochem Biophys Res Commun. 2001, 287: 648-655. 10.1006/bbrc.2001.5654CrossRefPubMed Wang FS, Wang CJ, Huang HJ, Chung H, Chen RF, Yang KD: Physical shock wave mediates membrane hyperpolarization and Ras activation for osteogenesis in human bone marrow stromal cells. Biochem Biophys Res Commun. 2001, 287: 648-655. 10.1006/bbrc.2001.5654CrossRefPubMed
29.
go back to reference Gotte G, Amelio E, Russo S, Marlinghaus E, Musci G, Suzuki H: Short-time non-enzymatic nitric oxide synthesis from L-arginine and hydrogen peroxide induced by shock waves treatment. FEBS Lett. 2002, 520: 153-155. 10.1016/S0014-5793(02)02807-7CrossRefPubMed Gotte G, Amelio E, Russo S, Marlinghaus E, Musci G, Suzuki H: Short-time non-enzymatic nitric oxide synthesis from L-arginine and hydrogen peroxide induced by shock waves treatment. FEBS Lett. 2002, 520: 153-155. 10.1016/S0014-5793(02)02807-7CrossRefPubMed
30.
go back to reference Mariotto S, de Prati AC, Cavalieri E, Amelio E, Marlinghaus E, Suzuki H: Extracorporeal shock wave therapy in inflammatory diseases: molecular mechanism that triggers anti-inflammatory action. Curr Med Chem. 2009, 16: 2366-2372. 10.2174/092986709788682119CrossRefPubMed Mariotto S, de Prati AC, Cavalieri E, Amelio E, Marlinghaus E, Suzuki H: Extracorporeal shock wave therapy in inflammatory diseases: molecular mechanism that triggers anti-inflammatory action. Curr Med Chem. 2009, 16: 2366-2372. 10.2174/092986709788682119CrossRefPubMed
31.
go back to reference Ciampa AR, de Prati AC, Amelio E, et al.: Nitric oxide mediates anti-inflammatory action of extracorporeal shock waves. FEBS Lett. 2005, 579: 6839-6845. 10.1016/j.febslet.2005.11.023CrossRefPubMed Ciampa AR, de Prati AC, Amelio E, et al.: Nitric oxide mediates anti-inflammatory action of extracorporeal shock waves. FEBS Lett. 2005, 579: 6839-6845. 10.1016/j.febslet.2005.11.023CrossRefPubMed
32.
go back to reference Nurzynska D, Meglio FD, Castaldo C, et al.: Shock waves activate in vitro cultured progenitors and precursors of cardiac cell lineages from the human heart. Ultrasound Med Biol. 2008, 34: 334-342. 10.1016/j.ultrasmedbio.2007.07.017CrossRefPubMed Nurzynska D, Meglio FD, Castaldo C, et al.: Shock waves activate in vitro cultured progenitors and precursors of cardiac cell lineages from the human heart. Ultrasound Med Biol. 2008, 34: 334-342. 10.1016/j.ultrasmedbio.2007.07.017CrossRefPubMed
33.
go back to reference Fisher AB, Chien S, Barakat AL, et al.: Endotheliam cellular responst to alstered shear s tress. Am J Physiol. 2001, 281: L529-L533. Fisher AB, Chien S, Barakat AL, et al.: Endotheliam cellular responst to alstered shear s tress. Am J Physiol. 2001, 281: L529-L533.
34.
go back to reference Ichioka S, Shibata M, Kosaka K, et al.: Effects of shear stress on wound healing angiogenesis in the rabbit ear chamber. J Surg Res. 1997, 72: 29-35. 10.1006/jsre.1997.5170CrossRefPubMed Ichioka S, Shibata M, Kosaka K, et al.: Effects of shear stress on wound healing angiogenesis in the rabbit ear chamber. J Surg Res. 1997, 72: 29-35. 10.1006/jsre.1997.5170CrossRefPubMed
35.
go back to reference Kang H, Bayless KJ, Kaunas R: Fluid shear stress modulates endothelial cell invasion in three-dimensional collagen matrices. Am J Physiol Heart Circ Physiol. 2008, 295: H2087-H2097. 10.1152/ajpheart.00281.2008CrossRefPubMedPubMedCentral Kang H, Bayless KJ, Kaunas R: Fluid shear stress modulates endothelial cell invasion in three-dimensional collagen matrices. Am J Physiol Heart Circ Physiol. 2008, 295: H2087-H2097. 10.1152/ajpheart.00281.2008CrossRefPubMedPubMedCentral
Metadata
Title
A modified regimen of extracorporeal cardiac shock wave therapy for treatment of coronary artery disease
Authors
Yu Wang
Tao Guo
Tie-kun Ma
Hong-yan Cai
Si-ming Tao
Yun-zhu Peng
Ping Yang
Ming-qing Chen
Yun Gu
Publication date
01-12-2012
Publisher
BioMed Central
Published in
Cardiovascular Ultrasound / Issue 1/2012
Electronic ISSN: 1476-7120
DOI
https://doi.org/10.1186/1476-7120-10-35

Other articles of this Issue 1/2012

Cardiovascular Ultrasound 1/2012 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine