2019, Number 3
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CorSalud 2019; 11 (3)
Results of low intensity extracorporeal shock wave therapy in patients with refractory angina
Rodríguez GE, Reyes HLM, Rodríguez GL, Correa MAM, Gómez GYC, Pérez GTJ
Language: Portugués
References: 26
Page: 203-210
PDF size: 414.34 Kb.
ABSTRACT
Introduction: Low intensity extracorporeal shock wave therapy has proven useful in the treatment of patients with refractory angina pectoris.
Objective: To assess the results of this type of therapy in patients with refractory
angina to drug treatment.
Method: A quasi-experimental study was carried out in 30 patients with refractory
angina pectoris to treatment, selected in a non-probabilistic way, taking into
account the following inclusion criteria. All patients were applied low intensity
extracorporeal shock wave therapy in the Cardiocentro Ernesto Guevara of Santa
Clara, in the period from January to December 2017. Epidemiological, clinical and
echocardiographic variables were analyzed at the beginning of the treatment and
six months after it was completed.
Results: The results obtained demonstrated an improvement of the functional
class (FC) of the Canadian Cardiovascular Society (CCS). Previous to treatment,
76.7% of patients had a FC III and 23.3% a FC IV, and after six months of completed
therapy, 73.3% improved to FC II and only 26.7 % remained in FC III. There was
also an improvement with respect to echocardiographic parameters such as
regional motility and left ventricular ejection fraction, which, in men, of an average
at the start of therapy of 37.81% it reached 44.14% at six months of completed; and
in women, of an average of 37.11% initially, it reached 47.22 % six months later.
Conclusions: The treatment with shock waves represents a therapeutic alternative
for patients with refractory angina.
REFERENCES
Kloner RA, Chaitman B. Angina and its manage-ment. J Cardiovasc Pharmacol Ther. 2017;22(3): 199-209.
Finegold JA, Asaria P, Francis DP. Mortality from ischaemic heart disease by country, region, and age: Statistics from World Health Organisation and United Nations. Int J Cardiol. 2013;168(2):934-45.
Park KE, Conti CR. Non-PCI/CABG therapies for refractory angina. Trends Cardiovasc Med. 2018; 28(3):223-8.
Henry TD, Satran D, Jolicoeur EM. Treatment of refractory angina in patients not suitable for re-vascularization. Nat Rev Cardiol. 2014;11(2):78-95.
Kikuchi Y, Ito K, Shindo T, Hao K, Shiroto T, Matsumoto Y, et al. A multicenter trial of extracorpo-real cardiac shock wave therapy for refractory angina pectoris: report of the highly advanced medical treatment in Japan. Heart Vessels. 2019; 34(1):104-13.
Burneikaitė G, Shkolnik E, Čelutkienė J, Zuozienè G, Butkuvienė I, Petrauskienė B, et al. Cardiac shock-wave therapy in the treatment of coronary artery disease: systematic review and meta-analysis. Cardiovasc Ultrasound [Internet]. 2017 [citado 14 Ene 2019];15(1):11. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5389112/pdf/12947_2017_Article_102.pdf
Yahata K, Kanno H, Ozawa H, Yamaya S, Tateda S, Ito K, et al. Low-energy extracorporeal shock wave therapy for promotion of vascular endothe-lial growth factor expression and angiogenesis and improvement of locomotor and sensory func-tions after spinal cord injury. J Neurosurg Spine. 2016 Dec;25(6):745-55.
Zhang C, Liu X, Wang X, Wang Q, Zhang Y, Ge Z. Efficacy of enhanced external counterpulsation in patients with chronic refractory angina on Cana-dian Cardiovascular Society (CCS) Angina Class: An updated meta-analysis. Medicine (Baltimore) [Internet]. 2015 [citado 14 Ene 2019];94(47):e2002. Disponible en: http://doi.org/10.1097/MD.0000000000002002
Kloppe A, Lawo T, Mijic D, Schiedat F, Muegge A, Lemke B. Long-term survival with Cardiac Con-tractility Modulation in patients with NYHA II or III symptoms and normal QRS duration. Int J Car-diol. 2016;209:291-5.
Myhr KA, Pedersen FH, Kristensen CB, Visby L, Hassager C, Mogelvang R. Semi-automated esti-mation of left ventricular ejection fraction by two-dimensional and three-dimensional echocardiog-raphy is feasible, time-efficient, and reproducible. Echocardiography. 2018;35(11):1795-805.
Tarkin JM, Kaski JC. Nicorandil and Long-acting Nitrates: Vasodilator Therapies for the Manage-ment of Chronic Stable Angina Pectoris. Eur Car-diol. 2018;13(1):23-28.
Church CC. A theoretical study of cavitation gen-erated by an extracorporeal shock wave lithotrip-ter. J Acoust Soc Am. 1989;86(1):215-27.
Crum LA. Cavitation microjets as a contributory mechanism for renal calculi disintegration in ESWL. J Urol. 1988;140(6):1587-90.
Jaalouk DE, Lammerding J. Mechanotransduction gone awry. Nat Rev Mol Cell Biol. 2009;10(1):63-73.
Ruiz-Garcia J, Lerman A. Cardiac shock-wave therapy in the treatment of refractive angina pec-toris. Interv Cardiol. 2011;3(2):191-201.
Mittermayr R, Antonic V, Hartinger J, Kaufmann H, Redl H, Téot L, et al. Extracorporeal shock wave therapy (ESWT) for wound healing: tech-nology, mechanisms, and clinical efficacy. Wound Repair Regen. 2012;20(4):456-65.
Takakuwa Y, Sarai M, Kawai H, Yamada A, Shiino K, Takada K, et al. Extracorporeal shock wave therapy for coronary artery disease: Relationship of symptom amelioration and ischemia improve-ment. Asia Ocean J Nucl Med Biol.;6(1):1-9.
Zuozienè G, Laucevičius A, Leibowitz D. Extra-corporeal shockwave myocardial revasculariza-tion improves clinical symptoms and left ventric-ular function in patients with refractory angina. Coron Artery Dis. 2012;23(1):62-7.
Silveira Duque A. Efeitos da terapia com ondas de choque na mecânica ventricular avaliada pela técnica de speckle tracking em pacientes com angina refratária [Tesis doctoral en Internet]. São Paulo: Faculdad de Medicina de la Universidad de São Paulo; 2017 [10 Feb 2019]. Disponible en: https://referenciaincor.com.br/wp-content/uploads/2018/01/pe_teses_literatura-incor_teses_24jan2018_anderson-silveira-duque.pdf
Prasad M, Wan Ahmad WA, Sukmawan R, Mag-sombol EB, Cassar A, Vinshtok Y, et al. Extracor-poreal shockwave myocardial therapy is effica-cious in improving symptoms in patients with re-fractory angina pectoris - A multicenter study. Coron Artery Dis. 2015;26(2):194-200.
Kikuchi Y, Ito K, Ito Y, Shiroto T, Tsuburaya R, Ai-zawa K, et al.: Double-blind and placebo-con-trolled study of the effectiveness and safety of ex-tracorporeal cardiac shock wave therapy for se-vere angina pectoris. Circ J. 2010;74(3):589-91.
Vainer J, Habets JH, Schalla S, Lousberg AH, de Pont CD, Vöö SA, et al. Cardiac shockwave thera-py in patients with chronic refractory angina pec-toris. Neth Heart J. 2016;24(5):343-9.
Faber L, Prinz C, Lindner O, Bogunovic N, Hering D, Burchert W, et al.: Echoguided extracorporeal shock wave therapy for refractory angina im-proves regional left ventricular function along with myocardial blood flow. Eur Heart J. 2014; 35(Abstract Suppl):658 [Resumen].
Wang J, Zhou C, Liu L, Pan X, Guo T. Clinical ef-fect of cardiac shock wave therapy on patients with ischaemic heart disease: a systematic review and meta-analysis. Eur J Clin Invest. 2015;45(12): 1270-85.
Wang Y, Guo T, Cai HY, Ma TK, Tao SM, Sun S, et al. Cardiac shock wave therapy reduces angina and improves myocardial function in patients with refractory coronary artery disease. Clin Car-diol. 2010;33(11):693-9.
Alunni G, Marra S, Meynet I, D'amico M, Elisa P, Fanelli A, et al. The beneficial effect of extracor-poreal shockwave myocardial revascularization in patients with refractory angina. Cardiovasc Re-vasc Med. 2015;16(1):6-11.