Extracorporeal cardiac shock wave therapy for ischemic heart disease

Abstract

Prognosis of severe ischemic heart disease with no indication of percutaneous coronary intervention or coronary artery bypass grafting still remains poor. Extracorporeal shock wave therapy was introduced for medical therapy more than 20 years ago to break up kidney stones. We have demonstrated that extracorporeal cardiac shock wave therapy at a low level of ~10% of energy density that used for urinary lithotripsy treatment, effectively induces coronary angiogenesis and improves myocardial ischemia in a porcine model of chronic myocardial ischemia in vivo. On the basis of the promising results in animal studies, we have recently developed a new, non-invasive angiogenic therapy with low-energy shock waves for ischemic heart disease. Our extracorporeal cardiac shock wave therapy improved symptoms and myocardial ischemia in patients with severe coronary artery disease. These beneficial effects of the shock wave therapy persisted for at least 12 months. Importantly, no procedural complications or adverse effects were noted. These results indicate that our extracorporeal cardiac shock wave therapy is an effective and non-invasive treatment for ischemic heart disease. To further confirm the usefulness and safety of our SW therapy, we are currently conducting the second clinical trial in a randomized and placebo-controlled manner.