Cardiac shock-wave therapy. a new method of therapeutic revascularisation of the heart

Abstract

Introduction: CHD is the leading cause of death throughout the world. Over the past 10 years in Ukraine mortality rate from cardiovascular disease has been 65%, in Moldova - 57%, when in the world ~ 30%. Despite a large variety of medicines to achieve long-term therapeutic results these are obtained in only a few cases. Unlike from the traditional methods of treatment, shock wave therapy has several advantages, which will be discussed in this work. Purpose and Objectives: The aim of this research was the study of innovative, safe and effective treatment of CHD - SWT. The study of method myocardial regeneration, angiogenesis, stem cell transplantation into the myocardium to patients with myocardial infarction. Materials and methods: SWT method has long been used in urology and orthopedics. In case of using in cardiology, acoustic wave energy is less than ~ 10 times, which ensures the safety of the method. In this work I used the experimental data modeling of biological models and clinical studies of patients' activated in the regional cardiac surgery center "of the city of Odessa. Statistical processing of data were carried out using Student t-test. Results: SWT is based on mechanical stress in focus zone by transmitting an acoustic wave energy. The result of the acoustic wave is growth the amount of mRNA which encodes the NO - synthase (eNOS), leading to vasodilatation and better circulation. It was also found that improvement of blood flow in the capillaries entails release vascular endothelial growth factor (VEGF), increase of flow circulating stem cells into the ischemic zone, and increase the number of new capillaries. As a result, on the periphery of destruction - there is observed cellular hypertrophy of cardiomyocytes. In the area of ischemia is observed replacement of myocardial tissue by connective tissue with atypical architectonic micro vasculature due to angiogenesis. SWT application results became: 1) Reduction of the functional class of angina 2) Reduction of usefulness of nitrate 3) Growth of tolerance to load 4) Improvement of myocardial perfusion SPECT in this 5) Improvement of LV function according to echocardiography Conclusion: Results of experimental and clinical studies allow characterizing SWT as a safe and highly effective method in treatment in patients with coronary artery disease.