Bansal Amit, Bulwer Bernard, von Krüchten Ricarda, Singh Jagkirat, Rehan Rajan, Doost Ata
Bergen COVID-19 Research group and Influenza Centre, Department of Clinical Science, University of Bergen, Bergen, Norway.
Department of Infectious Diseases, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia.
Struct Heart. 2024 Jul 16;9(2):100349. doi: 10.1016/j.shj.2024.100349. eCollection 2025 Feb.
Cardiovascular diseases (CVDs) remain the leading cause of morbidity and mortality globally, placing an immense burden on health care costs worldwide. The emergence of therapeutic ultrasound-based therapies in the CVD management represents a promising innovative strategy beyond current established approaches. This paper explores three distinct modalities of ultrasound-based therapies-high-intensity focused ultrasound, extracorporeal shock wave therapy, and low-intensity pulsed ultrasound-each characterized by unique acoustic parameters and mechanisms of action tailored to specific therapeutic outcomes. High-intensity focused ultrasound was shown to be beneficial as an adjunct in the treatment of myocardial infarction and arrhythmias. It has also been investigated for the treatment of resistant hypertension, symptomatic aortic valve stenosis, arterial stenosis, tumors, hypertrophic cardiomyopathy, and external cardiac pacing. Extracorporeal shock wave therapy was shown to be beneficial in the treatment of chronic refractory angina pectoris, while low-intensity pulsed ultrasound was shown to be beneficial in dissolving blood clots and improving blood flow in the treatment of acute pulmonary embolism, despite its association with an increased risk of bleeding. Ultrasound-based therapies are, therefore, a potential adjunct and comparatively safe adjuncts for managing challenging CVD cases. Further investigations are essential to validate their long-term effectiveness and safety, particularly for high-risk individuals susceptible to postprocedural complications.
心血管疾病（CVDs）仍然是全球发病和死亡的主要原因，给全球医疗保健成本带来了巨大负担。基于治疗性超声的疗法在心血管疾病管理中的出现，代表了一种超越现有既定方法的有前景的创新策略。本文探讨了基于超声的三种不同疗法——高强度聚焦超声、体外冲击波疗法和低强度脉冲超声，每种疗法都具有独特的声学参数和作用机制，以适应特定的治疗效果。高强度聚焦超声已被证明作为辅助手段在治疗心肌梗死和心律失常方面有益。它还被研究用于治疗顽固性高血压、有症状的主动脉瓣狭窄、动脉狭窄、肿瘤、肥厚型心肌病以及体外心脏起搏。体外冲击波疗法已被证明在治疗慢性难治性心绞痛方面有益，而低强度脉冲超声在溶解急性肺栓塞中的血栓和改善血流方面已被证明有益，尽管其与出血风险增加有关。因此，基于超声的疗法是管理具有挑战性的心血管疾病病例的潜在辅助手段且相对安全。进一步的研究对于验证其长期有效性和安全性至关重要，特别是对于易发生术后并发症的高危个体。
