학술논문
Rapid Fire Abstract session: multimodality imaging of ischaemic heart disease
Document Type
Article
Author
Faber, L; Lindner, O; Bogunovic, N; Hering, D; Burchert, W; Horstkotte, D; Nel, K T; Senior, R; Anstey, CM; Begley, J; Byrne, CD; Kaski, J; Bull, R; Boos, CJ; Greaves, K; Trifunovic, D; Stankovic, S; Stepanovic, J; Orlic, D; Banovic, M; Tesic, M; Petrovic, O; Petrovic, M; Djordjevic-Dikic, A; Vujisic-Tesic, B; Rodero, S; Mutuberria, M; Rodriguez-Palomares, J; Terricabras, M; Gutierrez, L; Teixido, G; Galian, L; Gonzalez-Alujas, T; Evangelista, A; Garcia-Dorado, D; Rodero, S; Mutuberria, M; Rodriguez-Palomares, J; Terricabras, M; Gutierrez, L; Teixido, G; Galian, L; Gonzalez-Alujas, T; Evangelista, A; Garcia-Dorado, D; Hammache, N; Voilliot, D; Brembilla-Perrot, B; Odille, F; Felblinger, J; Mandry, D; Marie, PY; Sadoul, N; Huttin, O; De Chillou, C; Olsen, F J; Jensen, JS; Pedersen, SH; Nochioka, K; Biering-Sorensen, T
Source
European Journal of Echocardiography; December 2015, Vol. 16 Issue: Supplement 2 pS139-S139, 1p
Subject
Language
ISSN
15252167; 15322114
Abstract
Purpose: Low-intensity shock wave (SW) therapy (SWT) has been shown to improve symptoms and exercise tolerance in patients (pts.) with coronary artery disease (CAD). Methods47 pts. with severe stable angina in advanced CAD (mean age 67 ± 10 years) not suitable for surgical or catheter-based revascularization underwent a series of 9 echocardiography-targeted SW applications (3 applications/week in week 1, 5, and 9). The antero-septal wall (LAD territory) was targeted in 20, the lateral wall (RCX territory) in 20, and the inferior wall (RCA territory) in 7 pts. A series of 300-500 shocks was applied per session. Anti-anginal drugs therapy was kept unchanged. Regional myocardial blood flow (MBF) to the targeted region was measured by NH3-PET, and longitudinal regional strain was assessed by speckle tracking echocardiography at baseline and 4-6 weeks after SWT. Results: Complications of SWT did not occur. At follow-up, 34 pts. (72%) reported improvement of angina to a tolerable level. CCS angina class decreased from 3.1 ± 0.6 to 2.5 ± 0.6 (p<0.001). MBF in the target region improved from 117 ± 41 mL/min/100g to 128 ± 46 mL/min/100g (p=0.037), while there was no change in the opposite wall not treated with SWT (135 ± 51 vs. 136 ± 51 ml/min/100g; p=0.9). Longitudinal strain of the midventricular segment in the region targeted by SWT improved from -14 ± 5 to -17 ± 6 %; p=0.04. Conclusions: SWT improved symptoms in a sizeable number of pts. with chronic refractory angina. Regional MBF improvement in the region targeted by SWT was documented by PET imaging, and functional improvement by speckle tracking echocardiography. Additional studies are warranted to clarify the role of SWT in the armamentarium for this challenging patient group.