Akbar Mohammad Rizki, Adiputro Dwi Laksono, Tiksnadi Badai Bhatara, Soeriadi Erwin Affandi, Hasan Melawati, Muttaqien Fauzan, Raharjo Pradana Pratomo, Nurazizah Eliza, Tarsidin Najmi Fauzan
Department of Cardiology and Vascular Medicine, Faculty of Medicine, Dr. Hasan Sadikin General Hospital, Padjadjaran University, Bandung, Indonesia.
Department of Cardiology and Vascular Medicine, Faculty of Medicine, Ulin General Hospital, Lambung Mangkurat University, Banjarmasin, Indonesia.
Front Cardiovasc Med. 2022 Feb 11;9:799834. doi: 10.3389/fcvm.2022.799834. eCollection 2022.
Extracorporeal shockwave myocardial revascularization (ESMR) is included in the guidelines only for patients with refractory angina pectoris having no option for invasive revascularization. We intend to report a case series with ESMR therapy is indicated patients with coronary artery bypass grafting-stable angina pectoris (CABG-SAP) who refuse the surgery, irrespective of angina symptoms.
We review medical records of patients with SAP admitted to ESMR therapy in Dr. Hasan Sadikin General Hospital, Bandung, Indonesia from January 2018 to December 2019. Recorded variables at baseline and after therapy extracted, namely, (1) ischemic response, double product, and (2) functional capacity measured as metabolic equivalent (MET) using treadmill test; (3) six-minute walking test distance achieved; and (4) quality of life using SF-36 Questionnaire.
A total of four indicated patients with CABG-SAP from 50 to 75 years old were included in this study. At baseline, one patient is CCS class I and two patients are CCS class II with SDS ranging from 3 to 17. Ischemic response improved in all the patients. The double product improved in patient 1 9,600-14,872 mm Hg × bpm, patient 2 9,460-10,640 mm Hg × bpm, and patient 4 17,220-20,480 mm Hg × bpm. The functional capacity improved in Patient 1 8.07-8.91 METs, patient 2 1.91-4.01 METs, patient 3 3.45-6.39 METs, and patient 4 3.9-4.43 METs. The 6-min walking distance improved in patient 1 540-570 m and patient 2 345-405 m. The CCS class, bodily pain, and general health domain scores improved in all patients.
ESMR therapy might be beneficial for indicated patients with CABG-SAP to improve ischemic response, functional capacity, and physical component of quality of life.
体外冲击波心肌血管重建术（ESMR）仅被纳入指南用于那些没有侵入性血管重建选择的难治性心绞痛患者。我们打算报告一组病例，这些病例表明ESMR疗法适用于拒绝手术的冠状动脉搭桥术-稳定型心绞痛（CABG-SAP）患者，无论其心绞痛症状如何。
我们回顾了2018年1月至2019年12月在印度尼西亚万隆哈桑·萨迪金综合医院接受ESMR治疗的SAP患者的病历。提取基线和治疗后的记录变量，即：（1）缺血反应、双乘积；（2）使用跑步机测试以代谢当量（MET）衡量的功能能力；（3）达到的六分钟步行测试距离；（4）使用SF-36问卷评估的生活质量。
本研究共纳入4例年龄在50至75岁之间的CABG-SAP适应证患者。基线时，1例患者为加拿大心血管学会（CCS）I级，2例患者为CCS II级，症状严重程度评分（SDS）范围为3至17。所有患者的缺血反应均有所改善。双乘积在患者1中从9600改善至14872 mmHg×bpm，患者2中从9460改善至10640 mmHg×bpm，患者4中从17220改善至20480 mmHg×bpm。功能能力在患者1中从8.07改善至8.91 METs，患者2中从1.91改善至4.01 METs，患者3中从3.45改善至6.39 METs，患者4中从3.9改善至4.43 METs。六分钟步行距离在患者1中从540改善至570 m，患者2中从345改善至405 m。所有患者的CCS分级、身体疼痛和总体健康领域评分均有所改善。
ESMR疗法可能对CABG-SAP适应证患者有益，可改善缺血反应、功能能力和生活质量的身体方面。
