Initial clinical experience with extracorporeal shock wave therapy in treatment of ischemic heart failure

Congest Heart Fail. Sep-Oct 2010;16(5):226-30. doi: 10.1111/j.1751-7133.2010.00182.x.


Previous experimental studies have suggested a beneficial effect of extracorporeal shock wave therapy (ESWT) in patients with ischemic heart failure. Twenty-four patients with ischemic heart failure and left ventricular ejection fraction (LVEF) <40% received ESWT in addition to their stable treatment. ESWT was performed in 9 sessions with 100 shocks per spot in viable segments detected by dobutamine stress echocardiography. Patients were evaluated at baseline and at 3 and 6 months after ESWT. Tc-99m MIBI single photon emission computed tomography was performed on inclusion and at 6 months. ESWT significantly decreased New York Heart Association class from 2.2±0.8 to 1.7±0.7 at 3 months (P<.01) and 6 months after ESWT (1.7±0.7). Six-minute walk test improved from 414±141 to 509±141 and 538±116 (P<.01) at 3 and 6 months, respectively. A steady decrease of Canadian Cardiovascular Society angina class from 2.6±0.7 to 2.1±0.8 and 1.9±0.7 (P<.01) at 3 and 6 months, respectively, was observed. A significant increase in LVEF at rest at 3 and 6 months after ESWT (from 32.2±6.0 to 34.8±9.6 and 37.7±9.5, P=.03, respectively) was noted. Summed rest score (from 23.9±8.1 to 21.4±7.1, P=.03) and stress score improvement (from 28.2±8.4 to 24.6±6.4, P=.04) by single photon emission computed tomography was registered. Significant clinical improvement accompanied by beneficial changes of LVEF and rest/stress perfusion was found after ESWT.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Echocardiography, Stress
  • Exercise Test
  • Heart Failure / diagnosis
  • Heart Failure / etiology
  • Heart Failure / therapy*
  • Humans
  • Myocardial Ischemia / complications
  • Myocardial Ischemia / physiopathology
  • Pain Measurement
  • Severity of Illness Index
  • Short-Wave Therapy*
  • Stroke Volume
  • Tomography, Emission-Computed, Single-Photon
  • Treatment Outcome