Effects of Cardiac Shock Wave Therapy on Myocardial Collateral Circulation and Global Cardiac Function after Acute Myocardial Infarction at Early Stage in Pigs

［Abstract］Objective To investigate the effects of CSWT on myocardial collateral circulation and global cardiac function after acute myocardial infarction at the early stage. Methods Thirty 3～5 months and 26～32kg domestic miniature pigs were enrolled in this study. The selected 30 pigs were randomly divided into three groups: CSWT group，pseudo-CSWT group and pseudo operation group. CSWT group was further divided into three subgroups according to treatment protocols. The collateral circulation vessel Rentrop score and global cardiac function were measured and evaluated by coronary artery angiography and left ventricular angiography，and then were compared among these groups，respectively. Results Compared with pseudo-CSWT group， collateral vessel Rentrop score was significantly higher in CSWT group［（2.05±0.11）vs（0.98±0.09），P = 0.03］. There was no significant difference in the collateral vessel Rentrop score between pseudo-CSWT group and pseudo-operation group［（0.98±0.09）Vs（0.86±0.03），P＞0.05］. There were significant differences in the collateral vessel Rentrop score among different subgroups in CSWT group，and the improving effects in subgroup of prolonged duration CSWT were better than other two subgroups. At the same time，the global cardiac function，including LVESV and LVEDV were significantly higher while and LVEF was lower in the CSWT group，pseudo-CSWT group than those in the sham operation. LVESV，LVEDV and LVEF in CSWT group were significantly better than those in pseudo-CSWT group. Conclusions Extracorporeal cardiac shock wave therapy could improve reconstructing micro-vascular circulation of ischemia myocardial，while result in an improvement in global cardiac function，especially，prolonged duration CSWT at early stage of acute myocardial infarction could better improve myocardial collateral vascular circulation. This may be one of the most important mechanisms for CSWT in improving of remodeling after ischemia heart disease in early stage.