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Development of Extracorporeal Shock Wave Therapy for the Treatment for Ischemic Cardiovascular Diseases

机译：缺血性心血管疾病治疗体外冲击波治疗的发展

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Cardiovascular diseases, such as coronary artery disease and peripheral artery disease, are the major causes of death in developed countries, and the number of elderly patients has been rapidly increasing worldwide. Thus, it is crucial to develop new non-invasive therapeutic strategies for these patients. We found that a low-energy shock wave (SW) (about 10% of the energy density that is used for urolithiasis) effectively increases the expression of vascular endothelial growth factor (VEGF) in cultured endothelial cells. Subsequently, we demonstrated that extracorporeal cardiac SW therapy with low-energy SW up-regulates the expression of VEGF, enhances angiogenesis, and improves myocardial ischemia in a pig model of chronic myocardial ischemia without any adverse effects in vivo. Based on these promising results in animal studies, we have subsequently developed a new, non-invasive angiogenic therapy with low-energy SW for cardiovascular diseases. Our extracorporeal cardiac SW therapy improved symptoms and myocardial perfusion evaluated with stress-scintigraphy in patients with severe coronary artery disease without indication of percutaneous coronary intervention or coronary artery bypass surgery. Importantly, no procedural complications or adverse effects were noted. The SW therapy was also effective in ameliorating left ventricular remodeling after acute myocardial infarction in pigs and in enhancing angiogenesis in hindlimb ischemia in animals and patients with coronary artery disease. Furthermore, our recent experimental studies suggest that the SW therapy is also effective for indications other than cardiovascular diseases. Thus, our extracorporeal cardiac SW therapy is an effective, safe, and non-invasive angiogenic strategy for cardiovascular medicine.
机译：心血管疾病，如冠状动脉疾病和周围动脉疾病，是发达国家死亡的主要原因，而老年患者的数量一直在全球迅速增加。因此，为这些患者开发新的非侵入性治疗策略至关重要。我们发现，低能量冲击波（SW）（用于尿石病的约10％的能量密度）有效地增加了血管内皮生长因子（VEGF）在培养的内皮细胞中的表达。随后，我们证明，具有低能量SW的体外心脏SW疗法对VEGF的表达，增强血管生成，并改善了慢性心肌缺血的猪模型中的心肌缺血，没有体内任何不良反应。基于这些有前途的动物研究结果，我们随后为心血管疾病的低能量SW制定了一种新的非侵入性血管生成治疗。我们的体外心脏SW治疗改善了患有严重冠状动脉疾病患者的应激闪烁评估的症状和心肌灌注，而不表明经皮冠状动脉介入或冠状动脉旁路手术。重要的是，没有注意到没有程序并发症或不利影响。 SW疗法在猪中急性心肌梗死后的改善左心室重塑以及增强动物和冠心病患者的血管生成，也有效。此外，我们最近的实验研究表明，SW疗法对除心血管疾病以外的迹象也是有效的。因此，我们的体外心脏SW疗法是一种有效，安全，无侵入性的心血管药物的血管生成策略。

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