Assessment Of The Effect Of Extracorporeal Cardiac Shock Wave Therapy In CAD By Exercise Stress Echocardiography

Objective:To evaluate the change of clinical symptom,cardiac reserve,life quality and exercise tolerance of extracorporeal cardiac shock wave therapy in coronary artery disease by using exercise stress echocardiography.Moreover,to investigate the effect and safety of extracorporeal cardiac shock wave therapy and to provide data support for cardiac rehabilitation.Methods:31 patients who were diagnosed of OMI in the First Affiliated Hospital of Kunming Medical University were selected from April 2017 to June 2017.Fourteen of the patients were randomized into the CS WT group(A group),there are 10 male and 4 female,average age 60.8±8.6 years,and 17 into the control group(B group),male 10 and female 22,average age 62.2±5.4 years.All patients signed written consent for participation in the clinical study.All patients were accepted the supine bicycle echocardiography before and after enrollment.And the CSWT group received 1 month extracorporeal cardiac shock wave therapy(one treatment session was 9 times,3 times within one week given on the 1st,3rd and 5th day of a week)and the control group received all the treatments except CSWT.Echocardiography was done to illustrate LVEDD and LVEF by using the Simpson method.We also selected the basic clinical data,like NYHA,SAQ,6MWT,laboratory examination,predicted METs,time in peak workload and achieved METs.Using statistical software of SPSS 22.0(SPSS,Chicago,IL,USA)to analyze the data.Continuous variables were expressed as mean ± SD and categorical variables were expressed as percentages.Nonparametric variables were expressed as the median(interquartile range).The comparison between groups was done by χ2 test.The pretreatment and post-treatment values were compared by paired t test or Wilcoxon signed rank test.P value of less than 0.05 was considered to be statistically significant.Results:The age,gender,body mass index(BMI),history of smoking,complication(hypertension,diabetes,hypercholesterolemia,hyperuricemia)and medication use for CAD(antiplatelet therapy,ACEI/ARB,aspirin,P blockers,CCB,statins,diuretics)between two groups and the laboratory examination before and after treatments of two groups were not significantly different.In the CSWT group,NYHA class decreased and SAQ,6MWT,LVEF increased significantly.After 1 month CSWT,the time in peak workload and achieved METs of CSWT group improved markedly.Conclusion:Cardiac shock wave therapy is a noninvasive,safe and effective cardiac rehabilitation.It can improve the clinical symptoms,cardiac reserve,exercise tolerance and life quality.Supine bicycle echocardiography can be used as an assessment method for patients with coronary heart disease after cardiac shock wave therapy.