1. The beneficial effect of extracorporeal shockwave myocardial revascularization: Two years of follow-up
- Author
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Domenica Zema, Umberto Barbero, Martina Pianelli, Federica Bongiovanni, Fiorenzo Gaita, Gianluca Alunni, Alessandro Vairo, and Salvo D'Amico
- Subjects
Extracorporeal Shockwave Therapy ,Male ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Myocardial Ischemia ,030204 cardiovascular system & hematology ,Revascularization ,Extracorporeal ,Angina Pectoris ,Angina ,Coronary artery disease ,03 medical and health sciences ,Myocardial perfusion imaging ,0302 clinical medicine ,Internal medicine ,medicine ,Myocardial Revascularization ,Humans ,030212 general & internal medicine ,Prospective Studies ,Prospective cohort study ,Aged ,Aged, 80 and over ,Tomography, Emission-Computed, Single-Photon ,medicine.diagnostic_test ,business.industry ,Myocardial Perfusion Imaging ,General Medicine ,Middle Aged ,medicine.disease ,Surgery ,Hospitalization ,Treatment Outcome ,Echocardiography ,Extracorporeal shockwave therapy ,Conventional PCI ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
Objectives Despite the advancements achieved by revascularization technique and pharmacological therapies, the number of patients with refractory angina (RA) is still high, carrying together a poor prognosis. Experimental data and small clinical studies suggest that the use of extracorporeal shockwave myocardial revascularization (ESMR) might improve symptoms of angina in patients with RA. The aim of our study is to evaluate the efficacy of cardiac shock wave therapy in a long term follow-up of patients with coronary artery disease (CAD) otherwise not suitable for revascularization. Methods We performed a prospective study enrolling patients with RA despite optimal medical therapy and without indication for further PCI or CABG. Characteristics such as angina class scores (CCS class score), nitroglycerin consumption and hospitalization were compared at baseline and 1, 6 and 12months after ESMR therapy. Results We enroll 72 patients with a mean age of 74.6±14.7years. We treated 440 echocardiographical segments of ischemical myocardium. During the longest published follow-up (2.88±1.65years, range 0.63–6.11) there was a significant reduction of medium CCS class score (from 2.78±0.67 to 1.44±0.6; p =0.0002), nitroglycerin consumption (67% vs 21%; p p Conclusion Our study confirms the beneficial effect of ESMR therapy on cardiac symptoms and the possibility to reduce hospitalizations in patients with refractory angina also in a long term follow up. It supports a role for ESMR as a non-invasive therapeutic option for patients with RA.
- Published
- 2017