[An experience of the use of a curative method of cardiac shock wave therapy in patients with ischemic heart disease].

Aim of the study was to assess effects of cardiac shock wave therapy (CSWT) in patients with coronary artery disease (CAD) with refractory stable angina pectoris. Seventeen CAD patients with refractory II-IV class angina (3 women and 14 men, mean age 67.4+/-8.6 years) received the course of 9 procedures of CSWT. All patients had I-III New York Heart Association (NYHA) class congestive heart failure. Before and after CSWT medical examination with life quality assessment by means of the Minnesota Living Questionnaire, echocardiography, veloergometry, myocardial perfusion imaging with single-photon emission computed tomography (SPECT) using 99M-Tc-methyl-iodine-benzyl-guanydin (MIBG) and Holter ECG monitoring was performed. The dynamics of pro-angiogenic factors (VEGF, HGF, FGF-) were also measured by ELISA, and of brain natriuretic peptide (Nt-proBNP) by the electrochemoluminescence method. Most patients (80%) had significant life quality (<0.01) and myocardial perfusion improvement. Episodes of angina pectoris and nitrate intake were more than twice decreased. There was a significant increase in exercise tolerance (p<0.01). Holter ECG monitoring showed decreasing of an average heart rate (p<0.02); no worsening of previous cardiac arrhythmias was observed. The significant (p<0.05) decreases in plasma Nt-proBNP and increases in VEGF concentration were revealed after CSWT. CSWT procedures were well tolerated. The results of our study confirm high effectiveness and safety of CSWT in complex treatment of patients with CAD, resistant angina pectoris, including patients after myocardial revascularization and with heart failure.