Improvement for myocardial preservation using extracorporeal shock wave

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Extracorporeal shock wave (SW) travels with the seed in water of ultrasound through body tissue, and could enhance angiogenesis in vitro. ESW has also been demonstrated to improve the local myocardial blood flow and cardiac function. The purpose of this study is to assess (1) whether ESW improves myocardial reperfusion injury, and (2) reduces the myocardial infarct size in the rabbit heart that received ESW therapy. The experimental protocol in the first was that the heart received ESW therapy for 3 days was harvested after cardioplegic arrest,and then stored in UW solution for 6 hours in 4℃. Reperfusion was performed using cross-circulation system. One hour after reperfusion, the aortic flow rate (AoF) was measured at left atrial pressure ( LAP) of 6mmHg in the working mode preparation. The heat rate was paced at 250/min, and the aortic afterload pressure was fixed at 60mmHg. The AoF at LAP of 6mmHg was 125±10.7ml/min in ESW therapy group ( L group) and 102 ±24.4m1/min in non-therapy group ( C group). ESW therapy has the tendency to improve myocardial function. Serum creatine kinase-MB ( CK-MB) on 60minute was 5.0±0.8ng/min in L group and 13.6±4.6ng/ml in C group, respectively. CK-MB on 120minute was 6.6±1.3ng/ml in L group and 23.4±9.4ng/ml in C group, respectively. The protocol in the second was that the left anterior descending artery of the heart received ESW therapy for 3 days was ligated, and we measured the rate of myocardial infarct area at risk (%AAR). The %AAR in L and C groups was 42% and 46%, respectively. There was no statistical difference between L and C groups.