Wu Xinze, Gu Minghong, Ma Yixuan, Song Peiyu, Fang Chenghu
Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, Tohoku University, Sendai, Japan.
Department of Pain Management, Jiangwan Hospital of Shanghai Hongkou District, Shanghai University of Medicine and Health Science Affiliated First Rehabilitation Hospital, Shanghai, China.
Front Cardiovasc Med. 2023 Jan 24;10:1088811. doi: 10.3389/fcvm.2023.1088811. eCollection 2023.
Ischemic heart disease (IHD) has a high prevalence and mortality rate, imposing a heavy burden on patients and society, and there is still a need to optimize treatment options for IHD patients. Cardiac shock wave therapy (CSWT) is gaining popularity as a new treatment for IHD patients. The objective of this meta-analysis is to reassess the effects of CSWT on IHD patients in light of the limited number of clinical studies included in previously published reviews, inconsistent methodological quality, and unclear outcomes.
From database creation until September 1, 2022, 4 English databases and 3 Chinese databases were rigorously searched for any current controlled trials of CSWT for IHD. The Cochrane Risk of Bias Assessment Tool was used for methodological quality assessment. Review Manager v.5.4 software was used for meta-analysis.
Nineteen published controlled trials totaling 1,254 subjects were included. Results showed that CSWT could enhance left ventricular function and myocardial viability, improve cardiac function and alleviate angina pectoris symptoms. The effects of CSWT and control groups on SAQ scores and exercise time were not statistically significant.
According to this systematic review and meta-analysis, CSWT may be beneficial for a number of IHD clinical indications. To verify these findings, more RCT studies with bigger sample numbers and higher methodological standards are required in the future.
缺血性心脏病(IHD)患病率和死亡率高,给患者和社会带来沉重负担,仍需优化IHD患者的治疗方案。心脏冲击波疗法(CSWT)作为IHD患者的一种新治疗方法正逐渐受到欢迎。鉴于先前发表的综述纳入的临床研究数量有限、方法学质量不一致以及结果不明确,本荟萃分析的目的是重新评估CSWT对IHD患者的影响。
从数据库创建至2022年9月1日,严格检索4个英文数据库和3个中文数据库,查找目前任何关于CSWT治疗IHD的对照试验。采用Cochrane偏倚风险评估工具进行方法学质量评估。使用Review Manager v.5.4软件进行荟萃分析。
纳入19项已发表的对照试验,共1254名受试者。结果显示,CSWT可增强左心室功能和心肌活力,改善心脏功能并缓解心绞痛症状。CSWT组与对照组在SAQ评分和运动时间方面的效果无统计学意义。
根据本系统评价和荟萃分析,CSWT可能对多种IHD临床指征有益。为验证这些发现,未来需要更多样本量更大、方法学标准更高的随机对照试验(RCT)研究。