Clinical effect of cardiac shock wave therapy on patients with ischaemic heart disease: a systematic review and meta-analysis.
Author: Wang J1,2, Zhou C1,2, Liu L3, Pan X1,2, Guo T1,2
Affiliation:
1Yunnan Provincial Cardiovascular Institute, Kunming, China.
2Department of Cardiology, 1st Affiliated Hospital of Kunming Medical University, Kunming, China.
3Department of Clinical Laboratory, 1st Affiliated Hospital of Kunming Medical University, Kunming, China.
Conference/Journal: Eur J Clin Invest.
Date published: 2015 Dec
Other:
Volume ID: 45 , Issue ID: 12 , Pages: 1270-85 , Special Notes: doi: 10.1111/eci.12546. Epub 2015 Nov 9. , Word Count: 256
BACKGROUND: After several years of study, CSWT has been initially applied to IHD treatment, but the actual effectiveness has never been well evaluated with a meta-analysis.
METHODS: MEDLINE, EMBASE, Science Direct, Cochrane Controlled Trials Register database and Chinese database were searched. The randomized controlled trials, and single-arm and cohort study related to in patients with IHD undergoing CSWT were included and 14 articles were finally analysed. The data related to the study design, patient characteristics and outcomes were extracted. All the selected data were calculated with random-effects models in weighted mean differences, and heterogeneity was carefully evaluated as well.
RESULTS: (i) Cardiac shock wave therapy improves the angina pectoris symptom (including the decrease of Canadian Cardiovascular Society class [-0·86 (-1·12, -0·65), P < 0·00001], nitroglycerin dosage (times/weeks) [-0·71 (-1·08, -0·33), P = 0·0002] and a increase of Seattle Angina Questionnaire score [5·64 (3·12, 8·15), P < 0·0001)]); (ii) CSWT leads to a reduce in heart failure (including a reduction of New York Heart Association functional class [-0·49 (-0·62, -0·37), P < 0·00001], a stable rise in 6-min walking distance [68·38 (39·70, 97·05), P < 0·00001] and a growth in left ventricular ejection fraction with echocardiography screening [6·73 (4·67,8·80), P < 0·00001]); (iii) CSWT improves myocardial viability within improving in total score of perfusion imaging [-5·19 (-8·08, -2·30), P = 0·0004] and total score of metabolism imaging [-5·33 (-7·77, -2·90), P < 0·0001].
CONCLUSIONS: The meta-analysis suggests that CSWT may offer beneficial effects to patients with IHD, although there was significant heterogeneity across the studies.
© 2015 Stichting European Society for Clinical Investigation Journal Foundation.
KEYWORDS: Angina pectoris; cardiac shock wave; ischaemic heart disease
PMID: 26444429 DOI: 10.1111/eci.12546
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