The effect of extracorporeal shockwave myocardial revascularization therapy to myocardial perfusion and function in indicated CABG-stable angina pectoris patients: case series.

OBJECTIVE Many studies have found a beneficial effect of Extracorporeal Shockwave Myocardial Revascularization (ESMR) therapy for refractory angina patients. However, clinical studies ESMR therapy for indicated coronary artery bypass grafting (CABG)-stable angina pectoris (SAP) patients are limited. PATIENTS AND METHODS Four indicated CABG-SAP patients CCS class I-III reviewed in this study. All patients refuse to CABG procedure. Data of myocardial perfusion and function from medical records were collected. RESULTS After ESMR therapy, summed rest score was improved in patient 1 from 14 to 8, Patient 2 from 10 to 5, and Patient 3 from 6 to 4. Summed stress score was improved in patient 1 from 31 to 19. Left ventricular ejection fraction was improved in patient 1 at rest from 59 to 67% and stress from 39 to 57%. The global longitudinal strain was improved in patient 1 from -16 to -20.9 and Patient 3 from -14.8 to -18.2. Diastolic dysfunction severity was improved in patient 2 and patient 3 from grade 2 to grade 1. CONCLUSIONS In our case series, ESMR therapy for indicated CABG-SAP patients might improve myocardial perfusion and function, especially for patients with a high ischemic burden.