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心脏冲击波治疗:一种治疗难治性心绞痛的替代非侵入性疗法。

Cardiac shock wave therapy: an alternative non-invasive therapy for refractory angina.

机构信息

Peking University First Hospital, Beijing, People's Republic of China.

出版信息

Eur Rev Med Pharmacol Sci. 2018 Aug;22(16):5402-5410. doi: 10.26355/eurrev_201808_15743.

Abstract

OBJECTIVE

Refractory angina (RFA), known as "no option angina" before, is increasing worldwide. The prognosis for RFA patients still remains poor due to the lack of effective treatments. The potential of cardiac shock wave therapy (CSWT) to treat RFA by promoting angiogenesis was first shown by Nishida et al in a porcine model of chronic ischemic cardiomyopathy. The main objective of this paper is to review the mechanisms of its action, influence on the cardiac tissue, and also clinical studies demonstrating its efficacy.

MATERIALS AND METHODS

This is a literature review of recent articles published on MEDLINE and SciELO databases in English.

RESULTS

Researchers found that CSWT leads to multiple biochemical effects, such as angiogenesis, inflammatory response modulation, ameliorate myocardial fibrosis, and so on. Based on the promising results above, a series of clinical studies have been performed. And the studies demonstrated that CSWT is associated with the improvement of angina symptoms, heart function, and myocardial perfusion for patients with refractory angina. No procedural complications or adverse effects were noted in these studies.

CONCLUSIONS

CSWT appears to be an effective, safe, and non-invasive approach to treat RFA.

摘要

目的

难治性心绞痛(RFA)以前被称为“无选择心绞痛”,在全球范围内呈上升趋势。由于缺乏有效的治疗方法,RFA 患者的预后仍然较差。Nishida 等人首次在慢性缺血性心肌病的猪模型中证明了心脏冲击波治疗(CSWT)通过促进血管生成治疗 RFA 的潜力。本文的主要目的是综述其作用机制、对心脏组织的影响以及证明其疗效的临床研究。

材料和方法

这是对 MEDLINE 和 SciELO 数据库中发表的英文近期文章的文献回顾。

结果

研究人员发现 CSWT 可导致多种生化效应,如血管生成、炎症反应调节、改善心肌纤维化等。基于上述有前景的结果,已经进行了一系列临床研究。这些研究表明,CSWT 与改善难治性心绞痛患者的心绞痛症状、心功能和心肌灌注有关。这些研究中未注意到与程序相关的并发症或不良反应。

结论

CSWT 似乎是一种有效、安全、非侵入性的治疗 RFA 的方法。

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