The Effectiveness and Safety of Cardiac Shock Wave Therapy in the Treatment of Ischemic Heart Disease with Refractory Angina Pectoris.

BACKGROUND

This study investigated the efficacy and safety profile of cardiac shock wave therapy (CSWT) in the treatment of ischemic heart disease (IHD) with refractory angina pectoris.

METHODS

A single-arm, pre-post prospective cohort study was conducted on 65 patients with IHD and refractory angina pectoris who were treated at the Department of Cardiology, 108 Military Central Hospital, between March 2015 and March 2021. The participants were prospectively monitored over a 6-month follow-up period.

RESULTS

Significant improvements were observed in angina symptoms, 6-minute walk test performance, Canadian Cardiovascular Society (CCS) angina classification, and New York Heart Association (NYHA) functional class. N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels decreased from 942.75 pg/mL to 410.45 pg/mL. Echocardiographic parameters demonstrated enhanced cardiac function, with the left ventricular ejection fraction (LVEF) increasing from 43.89 ± 12.27% to 48.48 ± 10.57% (p < 0.05). The wall motion septal index (WMSI) decreased from 1.54 ± 0.18 to 1.24 ± 0.12, while global longitudinal strain (GLS) improved from -10.28 ± 2.82 to -12.74 ± 2.42. Myocardial perfusion imaging revealed marked reductions in summed stress score (SSS: 17.45 ± 8.61 vs 12.18 ± 7.89), summed rest score (SRS: 11.09 ± 7.74 vs 9.46 ± 7.23), and summed difference score (SDS: 4.37 ± 2.31 vs 2.57 ± 1.56; all p < 0.05). Severe perfusion defects decreased from 46.2% to 12.3% and extensive perfusion defect areas decreased from 60% to 26.2%. No adverse events, including arrhythmias or elevated cardiac enzyme levels, were reported.

CONCLUSION

Cardiac shock wave therapy is effective in patients with ischemic heart disease and refractory angina, as evidenced by improvements in clinical, functional, and imaging parameters, along with a favourable safety profile.