Open AccessCardiac shock wave therapy: assessment of safety and new insights into mechanisms of tissue regeneration
Author(s) -
Di Meglio Franca,
Nurzynska Daria,
Castaldo Clotilde,
Miraglia Rita,
Romano Veronica,
De Angelis Antonella,
Piegari Elena,
Russo Sergio,
Montagnani Stefania
Publication year - 2012
Publication title -
journal of cellular and molecular medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.44
H-Index - 130
eISSN - 1582-4934
pISSN - 1582-1838
DOI - 10.1111/j.1582-4934.2011.01393.x
Subject(s) - ejection fraction , medicine , cardiac function curve , fibrosis , heart failure , cardiology , inflammation , population , myocardial infarction , cardiac fibrosis , regeneration (biology) , myocardial fibrosis , pathology , biology , environmental health , microbiology and biotechnology
Although low‐energy extracorporeal cardiac shock wave (ECSW) therapy represents an attractive non‐invasive treatment option for ischaemic heart disease, the precise mechanisms of its action and influence on the cardiac tissue remain obscure. The goal of this study was to evaluate the effects of SW application on cardiac function and structure. Four‐month‐old Fisher 344 rats were subjected to ECSW therapy. Echocardiographic measurements of cardiac function were performed at baseline and at 1 and 3 months after treatment. Signs of inflammation, apoptosis and fibrosis were evaluated by immunohistochemistry in the control and treated hearts. ECSW application did not provoke arrhythmia or increase the troponin‐I level. At all time points, the left ventricular ejection fraction and fractional shortening remained stable. Histological analysis revealed neither differences in the extracellular matrix collagen content nor the presence of fibrosis; similarly, there were no signs of inflammation. Moreover, a population of cardiac cells that responded eagerly to ECSW application in the adult heart was identified; c‐kit–positive, Ki67‐positive, orthochromatic cells, corresponding to cardiac primitive cells, were 2.65‐fold more numerous in the treated myocardium. In conclusion, non‐invasive ECSW therapy is a safe and effective way of activating cardiac stem cells and myocardial regeneration. Because many factors influence cellular turnover in the ischaemic myocardium during the course of ischaemic heart disease, cardiac remodelling, and heart failure progression, studies to identify the optimal treatment time are warranted.