Cardiac schockwave therapy in the treatment of ischemic heart disease patiens with refractive angina pectoris

Abstract

Objective: To evaluate of the effectiveness of cardiac shockwave therapy in the treatment of ischemic heart disease with refractive angina pectoris. Subject and method: A prospective, cross-sectional study with comparison and follow-up for 6 months on 50 patients with refractive angina pectoris from January 2017 to January 2020. The protocol application of 100 shocks/spot at 0.09mJ/mm2 energy flux density for 3 - 6 spots each time, with three times per week at each series for three series at 1, 5, 9 weeks. Result: The average age was 71.32 ± 10.5 years, men accounted for 78%. The symptoms of angina improved significantly (amount of chest pain 5.87 ± 2.7 to 0.28 ± 0.45 times; Nitrat consumed per week from 6.3 ± 3.5 to 0.3 ± 0.5 tablets/week). The 6-minute walking test all improved (278.1 ± 71m compared with 390.5 ± 42.3m). CCS angina class improved significant. NYHA grade improved significantly (NYHA III from 40.7% to 11.1%, NYHA II from 51.9% to 33.3%). Pro-BNP decreased (994.99 ± 1708.9 to 429.0 ± 453.9 pg/ml). WSMI decreased from 1.49 ± 0.22 to 1.24 ± 0.12, GLS improved from -9.79 ± 2.68 to -12.7 ± 2.42. Average score of SSS, SRS, SDS markedly improved with p<0.05 by SPECT. The degree of severe perfusion defect and the wide perfusion defect area decreased significantly after treatment by 52% to 12% and 58% to 28%, respectively. Conclusion: Cardiac shockwave therapy improved clinical symptoms and increased myocardial perfusion in ischemic heart disease with refractive angina pectoris.