Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2022 Feb 11:9:799834.
doi: 10.3389/fcvm.2022.799834. eCollection 2022.

Case Series: Extracorporeal Shockwave Myocardial Revascularization Therapy Improves Ischemic Response, Functional Capacity, and Quality of Life in Indicated CABG-Stable Angina Pectoris Patients

Mohammad Rizki Akbar  1 , Dwi Laksono Adiputro  2 , Badai Bhatara Tiksnadi  1 , Erwin Affandi Soeriadi  3 , Melawati Hasan  1 , Fauzan Muttaqien  2 , Pradana Pratomo Raharjo  1 , Eliza Nurazizah  1 , Najmi Fauzan Tarsidin  1
Affiliations
Case Reports

Case Series: Extracorporeal Shockwave Myocardial Revascularization Therapy Improves Ischemic Response, Functional Capacity, and Quality of Life in Indicated CABG-Stable Angina Pectoris Patients

Mohammad Rizki Akbar et al. Front Cardiovasc Med. .

Abstract

Introduction: Extracorporeal shockwave myocardial revascularization (ESMR) is included in the guidelines only for patients with refractory angina pectoris having no option for invasive revascularization. We intend to report a case series with ESMR therapy is indicated patients with coronary artery bypass grafting-stable angina pectoris (CABG-SAP) who refuse the surgery, irrespective of angina symptoms.

Methods: We review medical records of patients with SAP admitted to ESMR therapy in Dr. Hasan Sadikin General Hospital, Bandung, Indonesia from January 2018 to December 2019. Recorded variables at baseline and after therapy extracted, namely, (1) ischemic response, double product, and (2) functional capacity measured as metabolic equivalent (MET) using treadmill test; (3) six-minute walking test distance achieved; and (4) quality of life using SF-36 Questionnaire.

Results: A total of four indicated patients with CABG-SAP from 50 to 75 years old were included in this study. At baseline, one patient is CCS class I and two patients are CCS class II with SDS ranging from 3 to 17. Ischemic response improved in all the patients. The double product improved in patient 1 9,600-14,872 mm Hg × bpm, patient 2 9,460-10,640 mm Hg × bpm, and patient 4 17,220-20,480 mm Hg × bpm. The functional capacity improved in Patient 1 8.07-8.91 METs, patient 2 1.91-4.01 METs, patient 3 3.45-6.39 METs, and patient 4 3.9-4.43 METs. The 6-min walking distance improved in patient 1 540-570 m and patient 2 345-405 m. The CCS class, bodily pain, and general health domain scores improved in all patients.

Conclusion: ESMR therapy might be beneficial for indicated patients with CABG-SAP to improve ischemic response, functional capacity, and physical component of quality of life.

Keywords: cardiac shock wave; case series; functional capacity; quality of life; stable angina.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
SPECT examination of patient 1 before ESMR therapy.
Figure 2
Figure 2
ECG changes during treadmill test at (A) baseline and (B) after ESMR therapy.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Knuuti J, Wijns W, Saraste A, Capodanno D, Barbato E, Funck-Brentano C, et al. . 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. Eur Heart J. (2020) 41:407–77. 10.1093/eurheartj/ehz425 - DOI - PubMed
    1. Guilbert JJ. The world health report 2002 - reducing risks, promoting healthy life. Educ Health. (2003) 16:230. 10.1080/1357628031000116808 - DOI - PubMed
    1. Mboi N, Murty Surbakti I, Trihandini I, Elyazar I, Houston Smith K, Bahjuri Ali P, et al. . On the road to universal health care in Indonesia, 1990–2016: a systematic analysis for the global burden of disease study 2016. Lancet. (2018) 392:581–91. 10.1016/S0140-6736(18)30595-6 - DOI - PMC - PubMed
    1. Spertus JA, Jones PG, Maron DJ, O'Brien SM, Reynolds HR, Rosenberg Y, et al. . Health-status outcomes with invasive or conservative care in coronary disease. N Engl J Med. (2020) 382:1408–19. 10.1056/NEJMoa1916370 - DOI - PMC - PubMed
    1. Qanitha A, Uiterwaal CSPM, Henriques JPS, Mappangara I, Amir M, Saing SG, et al. . Adherence to guideline recommendations for coronary angiography in a poor South-East Asian setting: impact on short- and medium-term clinical outcomes. Sci Rep. (2019) 9:19163. 10.1038/s41598-019-55299-0 - DOI - PMC - PubMed

Publication types