Miokardo smūginės bangos terapijos veiksmingumas asmenims, sergantiems stabilia krūtinės angina: atsitiktinių imčių, trigubai aklas, imitacinės procedūros kontroliuojamas tyrimas

Coronary artery disease (CAD) is recognized to be a leading reason of adult mortality worldwide. Many patients experience persistent symptoms despite revascularization procedures and modern medical treatment. Experimental studies demonstrated that cardiac shock wave therapy (CSWT) might promote angiogenesis and improve myocardial function in a model of myocardial ischemia. The purpose of our study was to study the impact of CSWT on exercise tolerance, angina symptoms, myocardial perfusion and contraction during stress in patients with CAD and objective evidence of myocardial ischemia, who are not candidates for traditional revascularization and experience angina despite optimal medical therapy. The systematic review and metaanalysis demonstrated that CSWT is a potentially effective new non-invasive option for patients with CAD, but up till now evidence was limited to small, single-centre studies with high risk of bias due to the absence of credible control and allocation procedures. The randomized, triple-blind, sham procedure controlled study included 72 patients, from 2 centres. Clinical variables improved in both intervention and placebo groups. The anti-ischemic CSWT effect is clearly proven by cardiac imaging techniques and ECG changes during stress (on perfusion, contractility and extent of myocardial ischemia). This study presumably shows the substantial reserve of symptomatic improvement in optimizing medical treatment and patients’ adherence