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冠状动脉旁路移植术后严重冠状动脉疾病患者心脏冲击波治疗的临床结果

Clinical Outcomes of Cardiac Shockwave Therapy in Severe Coronary Artery Disease Patients after Coronary Artery Bypass Grafting.

作者信息

Wang Jiannan, Jia Na, Liu Baoyi, Zhang Ruisheng, Liu Bing, Lan Ming, Liu Junmeng, Yao Zhiming, He Qing

机构信息

Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences.

Graduate School of Peking Union Medical College.

出版信息

Int Heart J. 2023 Mar 31;64(2):137-144. doi: 10.1536/ihj.22-481. Epub 2023 Mar 15.

DOI:10.1536/ihj.22-481
PMID:36927932
Abstract

Cardiac shockwave therapy (CSWT) is a noninvasive treatment for patients with refractory angina or myocardial ischemia. This study aims to evaluate the potential beneficial effect and safety of CSWT in patients with severe coronary artery disease (CAD) who have undergone coronary artery bypass grafting (CABG).This was a single-arm prospective cohort study. A total of 30 patients with severe CAD who were not suitable for coronary revascularization and who had undergone CABG were enrolled. All patients received CSWT for nine sessions. Evaluation was performed before and after CSWT, including the Canadian Cardiovascular Society (CCS) classification, New York Heart Association (NYHA) classification, 6-minute walk test (6MWT), Seattle Angina Questionnaire (SAQ) score, nitroglycerin dosage, echocardiography, myocardial perfusion imaging (MPI), and safety parameters. All patients were followed up at both 1 month and 9 months after CSWT.After treatment, CSWT significantly improved CCS classification (P < 0.05), NYHA classification (P < 0.05), nitroglycerin dosage (P < 0.001), and 6MWT (P < 0.05) at 1 month and 9 months after CSWT. SAQ score (P < 0.05) and left ventricular ejection fraction (LVEF; P = 0.037) by echocardiography significantly improved at 1 month after CSWT. Significant decreases in summed stress score (SSS), summed difference score (SDS), ischemic area stress, and ischemic area difference by MPI were observed at 1 month and 9 months after CSWT (P < 0.01). There were no changes in safety parameters before and after CSWT.CSWT may have a beneficial effect on improving myocardial perfusion, clinical symptoms, exertional capacity, and quality of life and is a safe alternative treatment for patients with severe CAD who have undergone CABG.

摘要

心脏冲击波疗法(CSWT)是一种用于难治性心绞痛或心肌缺血患者的非侵入性治疗方法。本研究旨在评估CSWT对接受冠状动脉旁路移植术(CABG)的严重冠状动脉疾病(CAD)患者的潜在益处和安全性。这是一项单臂前瞻性队列研究。共纳入30例不适合进行冠状动脉血运重建且已接受CABG的严重CAD患者。所有患者接受9次CSWT治疗。在CSWT前后进行评估,包括加拿大心血管学会(CCS)分级、纽约心脏协会(NYHA)分级、6分钟步行试验(6MWT)、西雅图心绞痛问卷(SAQ)评分、硝酸甘油用量、超声心动图、心肌灌注成像(MPI)和安全性参数。所有患者在CSWT后1个月和9个月进行随访。治疗后,CSWT在CSWT后1个月和9个月时显著改善了CCS分级(P<0.05)、NYHA分级(P<0.05)、硝酸甘油用量(P<0.001)和6MWT(P<0.05)。CSWT后1个月时,SAQ评分(P<0.05)和超声心动图测得的左心室射血分数(LVEF;P = 0.037)显著改善。CSWT后1个月和9个月时,MPI测得的总应力评分(SSS)、总差异评分(SDS)、缺血区应力和缺血区差异显著降低(P<0.01)。CSWT前后安全性参数无变化。CSWT可能对改善心肌灌注、临床症状、运动能力和生活质量有有益作用,是接受CABG的严重CAD患者的一种安全替代治疗方法。

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Clinical Outcomes of Cardiac Shockwave Therapy in Severe Coronary Artery Disease Patients after Coronary Artery Bypass Grafting.冠状动脉旁路移植术后严重冠状动脉疾病患者心脏冲击波治疗的临床结果
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Cardiac shock wave therapy reduces angina and improves myocardial function in patients with refractory coronary artery disease.心脏冲击波治疗可减少难治性冠心病患者的心绞痛并改善心肌功能。
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[Effects of extracorporeal cardiac shock wave therapy in patients with ischemic heart failure].[体外心脏冲击波疗法对缺血性心力衰竭患者的影响]
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