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Cardiac shock wave therapy improves myocardial perfusion and preserves left ventricular mechanics in patients with refractory angina: A study with speckle tracking echocardiography
Author(s) -
Duque Anderson S.,
Ceccon Conrado L.,
Mathias Wilson,
Majesky Joana Diniz,
Gowdak Luis H.,
Sbano João C. N.,
Cesar Luis Antonio Machado,
Abduch Maria Cristina,
Lima Márcio S. M.,
Dourado Paulo M. M.,
Cruz Cecilia B. B. V.,
Tsutsui Jeane M.
Publication year - 2018
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.14054
Subject(s) - medicine , sss* , cardiology , perfusion , myocardial perfusion imaging , ejection fraction , speckle tracking echocardiography , angina , canadian cardiovascular society , heart failure , myocardial infarction
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.