INTRODUCTION: New myocardial revascularization method – myocardial shock wave therapy (MSWT) – improves left ventricular (LV) function in clinical studies. Our aim was to investigate does the effect of MSWT depend on left ventricular ejection fraction.
MATHERIAL AND METHODS: Forty patients with Canadian Cardiovascular Society (CCS) class III-IV angina despite medical therapy were selected for MSWT. 30% of patients did not have clear myocardial infarction previously. 70% of study subjects had one or more myocardial infarctions. LV ejection fraction (EF) was documented by cardiac MRI. Myocardial ischemia was evaluated by technetium-99m SPECT evaluating transient ischemic dilation (TID) or dobutamine stress echocardiography (DSE) evaluating wall motion score index (WMSI). Full functional evaluation was performed before and 6 months after study therapy. MSWT was applied using commercially available MSWT generator system under echocardiographic guidance. The statistical software package SPSS 17.0 (version for Windows) was used for the data analysis. Patients were subdivided into two groups based on LV EF the median value 52%.
RESULTS: The LV EF in the Group I was 42,77 ± 9,46 %, in the Group II 60,56 ± 5.06 %. After treatment LV EF, LV stroke volume, WMSI and TID significantly more improved in the Group I (see Table).
CONCLUSIONS: Cardiac shock wave therapy is a safe and effective treatment method for end-stage ischemic heart disease. CSWT improves patients condition and may be applied as a treatment method at clinic and recommended to patients. It was demonstrated that myocardial shock wave therapy is relatively more effective for the patients with more advanced systolic dysfunction estimated by MRI.
