Graber Michael, Nägele Felix, Hirsch Jakob, Pölzl Leo, Schweiger Victor, Lechner Sophia, Grimm Michael, Cooke John P, Gollmann-Tepeköylü Can, Holfeld Johannes
Department of Cardiac Surgery, Medical University of Innsbruck, Innsbruck, Austria.
Department of Cardiovascular Sciences, Center for Cardiovascular Regeneration, Houston Methodist Research Institute, Houston, TX, United States.
Front Cardiovasc Med. 2022 May 12;9:875965. doi: 10.3389/fcvm.2022.875965. eCollection 2022.
Over the past decades, shockwave therapy (SWT) has gained increasing interest as a therapeutic approach for regenerative medicine applications, such as healing of bone fractures and wounds. More recently, pre-clinical studies have elucidated potential mechanisms for the regenerative effects of SWT in myocardial ischemia. The mechanical stimulus of SWT may induce regenerative effects in ischemic tissue growth factor release, modulation of inflammatory response, and angiogenesis. Activation of the innate immune system and stimulation of purinergic receptors by SWT appears to enhance vascularization and regeneration of injured tissue with functional improvement. Intriguingly, small single center studies suggest that SWT may improve angina, exercise tolerance, and hemodynamics in patients with ischemic heart disease. Thus, SWT may represent a promising technology to induce cardiac protection or repair in patients with ischemic heart disease.
在过去几十年中,冲击波疗法(SWT)作为一种用于再生医学应用(如骨折和伤口愈合)的治疗方法,越来越受到关注。最近,临床前研究已经阐明了SWT在心肌缺血中产生再生效应的潜在机制。SWT的机械刺激可能在缺血组织中诱导再生效应,包括生长因子释放、炎症反应调节和血管生成。SWT激活先天免疫系统并刺激嘌呤能受体,似乎可增强受伤组织的血管化和再生,并改善其功能。有趣的是,小型单中心研究表明,SWT可能改善缺血性心脏病患者的心绞痛、运动耐量和血流动力学。因此,SWT可能是一种在缺血性心脏病患者中诱导心脏保护或修复的有前景的技术。