Cardiac shock wave therapy improves myocardial perfusion and preserves left ventricular mechanics in patients with refractory angina: A study with speckle tracking echocardiography.

Autor: Duque AS; Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil., Ceccon CL; Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil., Mathias W Jr; Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil.; Fleury Medicine and Health, Sao Paulo, Brazil., Majesky JD; Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil., Gowdak LH; Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil., Sbano JCN; Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil.; Fleury Medicine and Health, Sao Paulo, Brazil., Cesar LAM; Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil., Abduch MC; Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil., Lima MSM; Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil.; Fleury Medicine and Health, Sao Paulo, Brazil., Dourado PMM; Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil., Cruz CBBV; Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil.; Fleury Medicine and Health, Sao Paulo, Brazil., Tsutsui JM; Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil.; Fleury Medicine and Health, Sao Paulo, Brazil.
Jazyk: angličtina
Zdroj: Echocardiography (Mount Kisco, N.Y.) [Echocardiography] 2018 Oct; Vol. 35 (10), pp. 1564-1570. Date of Electronic Publication: 2018 Jul 01.
DOI: 10.1111/echo.14054
Abstrakt: Background: Cardiac shockwave therapy (CSWT) is a new potential option for the treatment of patients with chronic coronary disease and refractory angina (RA). We aimed to study the effects of CSWT on left ventricular myocardial perfusion and mechanics in patients with RA.
Method: We prospectively studied 19 patients who underwent CSWT. Left ventricular mechanics were evaluated by speckle tracking echocardiography (STE), and myocardial perfusion by single-photon emission computed tomography, using stress/rest-Technetium-99 m Sestamibi, for determination of summed stress score (SSS). Canadian Cardiac Society (CCS), New York Heart Association (NYHA), and quality of life by Seattle Angina Questionnaire (SAQ) were assessed at baseline and 6 months after therapy.
Results: CSWT therapy was applied without major side effects. At baseline, 18 patients (94.7%) had CCS class III or IV, and after CSWT there was reduction to 3 (15.8%), P = .0001, associated with improvement in SAQ (38.5%; P < .001). Thirteen (68.4%) had class NYHA III or IV before treatment, with significant reduction to 7 (36.8%); P = .014. No change was observed in the global SSS from baseline to 6-month follow-up (15.33 ± 8.60 vs 16.60 ± 8.06; P = .157). However, there was a significant reduction in the average SSS of the treated ischemic segments (2.1 ± 0.87 pre vs 1.6 ± 1.19 post CSWT; P = .024). Global longitudinal strain by STE remained unaltered (-13.03 ± 8.96 pre vs -15.88 ± 3.43 6-month post CSWT; P = .256).
Conclusion: CSWT is a safe procedure for the treatment of patients with RA that results in better quality of life, improvement in myocardial perfusion of the treated segments with preservation of left ventricular mechanics.
(© 2018 Wiley Periodicals, Inc.)
Databáze: MEDLINE
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