Extracorporeal cardiac shock wave therapy improves left ventricular remodeling after acute myocardial infarction in pigs
Extracorporeal cardiac shock wave therapy improves left ventricular remodeling after acute myocardial infarction in pigs
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DOI：
10.1097/mca.0b013e328089f19b
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发表时间：
2007-08-01
影响因子：
1.8
通讯作者：
Shimokawa, Hiroaki
中科院分区：
文献类型：
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作者：
Uwatoku, Toyokazu;Ito, Kenta;Shimokawa, Hiroaki
目的我们最近证实了低能量体外冲击波疗法改善了猪和人的慢性心肌缺血。在这项研究中，我们研究了我们的冲击波疗法是否也有效地改善了猪急性心肌梗死后的左心室重构。方法通过手术切除左回旋支冠状动脉近端节段(n=20)建立急性心肌梗死模型。早期治疗方案在急性心肌梗死后3d开始冲击波治疗，晚期治疗方案在急性心肌梗死后4周开始治疗(n=5)。结果在早期治疗方案中，与对照组相比，冲击波组的左心室射血分数较高(42+/-vs.32+/-1%，P<0.001)，左室舒张末容量较小(95.1mlvs.99.2ml，P<；0.05)。此外，与对照组相比，冲击波组室壁增厚分数(32+/-1vs.28+/-1%，P<；0.0001)、局部心肌血流量(1.7+/-0.2vs.1.0+/-0.1ml/min/g，P<；0.01)和交界区毛细血管数(1348+/-15vs.938+/-34 mm(2)，P<；0.01)均显著改善。结论我们的体外心脏冲击波治疗在急性心肌梗死后的早期阶段也是一种有效的非侵入性治疗方法，可以改善急性心肌梗死后的左室重构。
Objective We have recently demonstrated that low-energy extracorporeal shock wave therapy improves chronic myocardial ischemia in pigs and humans. In this study, we examined whether our shock wave therapy is also effective at improving left ventricular remodeling after acute myocardial infarction in pigs.Methods Acute myocardial infarction was created by surgically excising the proximal segment of the left circumflex coronary artery (n=20). In the early treatment protocol, the shock wave therapy was started 3 days after acute myocardial infarction, whereas in the late treatment protocol, the therapy was started 4 weeks after acute myocardial infarction (n=5 each). The remaining animals were treated in the same manner, but without the shock wave treatment in each protocol (n=5 each).Results In the early treatment protocol, left ventricular ejection fraction was higher (42 +/- vs. 32 +/- 1 %, P < 0.001) and left ventricular end-diastolic volume was smaller (95 1 vs. 99 2 ml, P < 0.05) in the shock wave group compared with the control group. Furthermore, wall thickening fraction (32 +/- 1 vs. 28 +/- 1 %, P < 0.01), regional myocardial blood flow (1.7 +/- 0.2 vs. 1.0 +/- 0.1 ml/min/g, P < 0.01), and number of capillaries in the border zone (1348 +/- 15 vs. 938 +/- 34 mm(2), P < 0.0001) were all significantly improved in the shock wave group compared with the control group. By contrast, in the late treatment group, no such beneficial effects of the shock wave therapy were noted.Conclusion These results suggest that our extracorporeal cardiac shock wave therapy is also an effective and noninvasive therapy for improving left ventricular remodeling after acute myocardial infarction when started in the early phase of the disorder.