Cardiac Shock Wave Therapy Ameliorates Myocardial Ischemia in Patients With Chronic Refractory Angina Pectoris: A Randomized Trial

Liu Weijing, Fan Ximin, Shen Jianying, Zhu Mengyun, Fan Xuehua, Xu Yawei, Hong Liqiong, Liu Weijing, Fan Ximin, Shen Jianying, Zhu Mengyun, Fan Xuehua, Xu Yawei, Hong Liqiong

Abstract

Background: Cardiac shock wave therapy (CSWT) is a non-invasive new option for the treatment of chronic refractory angina pectoris (CRAP). This study aimed to evaluate the safety and efficiency of CSWT in the treatment of CRAP. Methods: Eighty-seven patients with CRAP were randomly allocated into CWST group (n = 46) and Control group (n = 41). Canadian Cardiovascular Society (CCS) grade of angina pectoris, Seattle Angina Questionnaire (SAQ) score, 6-min walk test (6MWT), weekly dosage of nitroglycerin, and myocardial perfusion on D-SPECT were determined at baseline and during the follow-up period. Adverse events were also evaluated. Results: CSWT was well-tolerated in the CSWT patients. CSWT significantly improved the CCS grade, SAQ score, and 6MWT (p < 0.05). Imaging examinations showed that the ischemic area was reduced after CSWT. However, no significant changes were observed in the Control group. Conclusions: CSWT may improve the myocardial perfusion and reduce clinical symptoms without increasing adverse effects in CRAP patients. It provides a non-invasive and safe clinical therapy for CRAP patients. Clinical Trial registration: www.ClinicalTrials.gov, identifier: NCT03398096.

Keywords: angina; angiogenesis; cardiac shock wave therapy; randomized trial; refractory angina pectoris.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2021 Weijing, Ximin, Jianying, Mengyun, Xuehua, Yawei and Liqiong.

Figures

Figure 1
Figure 1
Flowchart of patient recruitment. CSWT, cardiac shock wave therapy; D-SPECT, dynamic single photon emission computed tomography.
Figure 2
Figure 2
D-SPECT of a patient. After CSWT, the ischemic myocardium at rest and stress procedure was significantly reduced at 6 months after treatment as compared to that before CSWT. (A) Before treatment at stress procedure. (B) Before treatment at rest procedure. (C) After treatment at stress procedure. (D) After treatment at rest procedure. Arrow: ischemic area. CSWT, cardiac shock wave therapy; D-SPECT, dynamic single photon emission computed tomography; LAD, left anterior descending artery; LCX, left circumflex coronary artery; RCA, right coronary artery.

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