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- Title
Extracorporeal Shock Wave Therapy as a New and Non-invasive Angiogenic Strategy.
- Authors
Ito, Kenta; Fukumoto, Yoshihiro; Shimokawa, Hiroaki
- Abstract
Ischemic heart disease is the leading cause of death and the number of refractory severe patients is increasing. Therefore, it is crucial to develop new therapeutic strategies for severe ischemic heart disease. We found that a low-energy shock wave (SW) (about 10% of energy density that used for endothelial cells based on this in vitro study, we have started in vivo studies and have demonstrated that extracorporeal cardiac shock wave therapy with a low-energy SW upregulates the expression of VEGF, induces neovascularication, and improves myocardial ischemia in a porcine model of chronic myocardial ischemia without any adverse effects in vivo. On the basis of the promising results in animal studies, we have subsequently developed a new, now-invasive angiogenic therapy with low-energy SW for ischemic heart disease. Our extracorporeal cardiac SW therapy improved symptoms and myocardial perfusion evaluated with stress-scintigraphy in patients with severe coronary artery disease without indication of pecutaneous coronary intervation of coronary bypass surgery. Importantly, no procedural complications or adverse effects were noted. The SW therapy was also effective to ameliorate LV remodelling after acute myocardial infraction in pigs and to enhance angiogenesis in hindlimb ischemia in rabbits. Based on these animal studies, we are also conducting clinical studies in patients with acute myocardial infraction and those with peripheral artery disease. Thus, our extracorporeal cardiac SW therapy is an effective, safe, and non-invasive angiogenic strategy in cardiovascular medicine and its indication is now rapidly expanding.
- Subjects
EXTRACORPOREAL shock wave therapy; CORONARY heart disease treatment; VASCULAR endothelial growth factors; NEOVASCULARIZATION; CORONARY artery bypass
- Publication
Tohoku Journal of Experimental Medicine, 2009, Vol 219, Issue 1, p1
- ISSN
0040-8727
- Publication type
Article
- DOI
10.1620/tjem.219.1