| Objectives: To use extracorporeal cardiac shock therapeutic apparatus carry through extracorporeal cardiac shock wave therapy (CSWT) for heart of acute myocardial infarction stage in pigs . By extracorporeal cardiac shock wave therapy (CSWT) , from three aspects : to probe into its expression condition with revascularization relative factors : that is expression condition of endothelial nitric oxide synthase (eNOS) and basic fibroblast growth factor (bFGF) ; ischemia regional myocardial perfusion condition; new capillary density condition of myocardial ischemia regional, and did synthetic judgment of effect and safety for treatment pigs with acute myocardial infarction(AMI)by extracorporeal cardiac shock wave therapy (CSWT).Methods: Choose coronary intervention methods, to embolize far-end of left anterior descending coronary artery, to make acute myocardial infarction (AMI) model of pigs. To take 12 cases of survive pigs to divide into therapy group of CSWT of 6 each, and control group of 6 each, therapy group of 1 , 3 , 5 days after acute myocardial infarction (AMI) received together three times treatmrnt of CSWT, 200 hit /point, total up12 points, energy was 0.09 mJ/mm2. Control group do not treatment. Before and after AMI, immediate at 1 , 3 , 5 days, 1,2,3,4 weeks , to extract Peripheral blood ,to use enzyme-linked immunosorbent assay detecting serum eNOS content; 3 days and 4 weeks before and after AMI, myocardial perfusion imaging of 99Tcm-MIBI was performed respectively to observe myocardial perfusion area; 4 weeks after AMI,to extract heart materials, to perfom immnohistochemical staining of von willebrand factor (vWF), counting newly born capillaries condition under the light microscope 400 times; using ransmission electron microscope, to observe myocardial cell apoptosis condition; detecting expression condition of eNOS and bFGF in myocardium tissue of different parts by fluorescent PCR. Results were analyzed with statistics, to contrast that they have or not statistic difference between two group.Results: Using ELISA method to determine serum eNOS: two groups' immediately serum concentrations of eNOS of post-operation of AMI were obviously reduced than the pre-operation . After CSWT treatment of post-operative 1day of treatment groups, its eNOS expression began to rise, and after third times treatment to achieve a peak, and to continue 2 3weeks, decline at 4 weeks . The eNOS expression of post-operative serum of control group showed that it was continuous reductive, 4w at post-operative was lowest . Two groups had statistical significance difference (P < 0.01); By SPECT(single photon emission computed tomography) to detect treatment group and control group , their SDS in early- late period of myocardial infarction were (8.55±1.48) points and (14.12±2.73) points respectively, The difference had statistical significance (P<0.05); myocardial histology detection of light microscope and ransmission electron microscope showed that inflammatory cells aggregation at infarctional fringe area of control group , interstitial fibrosis was obvious than treatment group ; on immunohistochemical capillary number aspects, capillary number of control group (1.65±0.78) also obviously less than the treatment group (498±1.32) (P < 0.05); use semi-quantitative RT-PCR, to detect expression condition of eNOS and bFGF in myocardial tissue of infarction borderline area , results showed that treatment group were obviously higher than control group (eNOS 27.705±4.13 vs 16.448±3.21; bFGF 32.571±4.23 vs 17.858±4.17, P<0.01)o There were no arrhythmia and heart failure ,and other side effects, in the process of shock wave.Conclusion: After pigs with acute myocardial infarction, to use CSWT treatment, it can make expression increase of eNOS and bFGF in serum and tissue of pigs, myocardial perfusion increase of ischemic area, increase of newly born capillaries number of ischemic myocardium. Use CSWT to treatment AMI is safe and effective.
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