Adapted from BMJ 29 June 2024
Localised shock wave treatment has been used to treat patients with tendinitis, non-healing bone fractures, chronic leg ulcers, soft tissue wounds, post-stroke spasticity and spinal cord injury.
Now, Austrian researchers have found a small, but definite effect, in heart muscle regeneration in patients who have coronary artery bypass surgery.
An electric current is applied to electrodes in water, not the patient, so they get a sonic shock rather than an electrical shock. The sonic wave cannot be heard by humans. They say that this, “activates the innate immune system of treated cells, leading to increased DNA accessibility and cellular plasticity, together with the secretion of angiogenic cytokines and growth factors. This induces angiogenesis in the hibernating myocardium. Newly formed vessels then support the recruitment of chronically under-supplied myocardium.”
In a trial of 63 patients undergoing CABG surgery, some had the sonic treatment and others had sham treatment. After a year, left ventricular ejection fraction in the shockwave group increased by 11.3% compared to 6.3% in the control group. The treated group could walk further in six minutes compared to the untreated group and also reported a better quality of life.
Lead researcher Johannes Holfield said, ” for the first time, we are seeing the heart muscle regenerate in a clinical setting, which could help millions of people.” Larger trials are now planned for chronic ischaemia patients.
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