Shocking the heart muscle like gravel allows angiogenesis to improve ischemia
Expert interview: Beijing Hospital Cardiology physician He Qing □ Attending physician Jia Na
Our reporter Jin Yu-ling
He Qing, chief physician, professor, doctoral tutor, Chinese Society of Physicians Cardiovascular Physicians Branch members, Beijing Medical Association Cardiology Committee of Experts, "Chinese Cardiovascular Journal" editor
The 72-year-old is often the old patient of Professor He Qing, professor of Cardiology of Beijing Hospital. On the morning of February 2, he came to the hospital for the fifth time to receive the treatment of "extracorporeal heart shock." After he was lying on his bed and lifted his shirt, Chest, cardiologist Dr Jana skilled operation of the machine, positioned under the guidance of the echocardiography treatment site, accompanied by 'loudspeaker, loudspeaker', the treatment began.
'Extracorporeal shock' therapy is a new technology for coronary heart disease that passed the European industry certification as early as 2004 and two years later our country also approved its entry into the Chinese market. After years of clinical research and careful validation, A few years before the domestic application.He Qing Professor told the "Life Times" reporter, coronary heart disease commonly used in the three major treatment methods, including drug treatment, interventional surgery (ie, stenting) and coronary artery bypass surgery.However, some patients with diffuse vascular lesions , Extensive, severe myocardial ischemia, not suitable for surgery; some patients have been done bypass or placed a number of stents, and the occurrence of severe vascular disease, frequent angina, but the heart can not afford re-surgery, shock therapy They bring hope for them.The essence of 'shock wave' is a kind of mechanical wave whose principle is relatively familiar to the people and similar to the extracorporeal lithotripsy technique commonly used in urology. It is a noninvasive physical therapy whose strength is only Gravel treatment of energy one tenth of the treatment of local myocardial by low-energy shock wave stimulation can reduce ischemic local inflammatory response and apoptosis, promote Myocardial formation of new blood vessels and inhibition of structural abnormalities in the left ventricle to reverse the myocardial ischemia caused by coronary lesions and improve myocardial blood supply and cardiac function.The course of treatment is usually 3 months, the first week of each month for 3 treatments , A total of 9 times, about 90 minutes.According to the treatment of patient feedback, usually 4 to 8 weeks after there will be more significant improvement.Often done bypass has been 7 years, the coronary artery is a bit blocked, but can no longer Surgery, so to try the shock treatment.He said: 'This is a very good way, I finished less than a month, walking was light and light. Treatment, the feeling is like a small needle gently tied to the skin, not Pain, nothing uncomfortable. "Dr. Jana added that very individual patients are more sensitive, may have skin redness, stinging and other mild discomfort, but can be tolerated after treatment. From the myocardial nuclide examination (a non-invasive Of the imaging examination can determine the state of myocardial perfusion) results, the end of a course of treatment, the vast majority of patients with myocardial ischemia can be significantly improved, there will be reduced chest tightness, chest pain, increased mobility Intuitive feeling.
Since shock wave therapy is safe, there are good results, can replace interventional or coronary surgery? Professor He Qing stressed that shock wave therapy is only an adjuvant therapy for coronary heart disease, in patients with surgical indications or should The first surgery, surgery can be opened directly to the large blood vessels, and shock wave therapy is mainly for small blood vessels or diffuse vascular lesions, the larger the role of blood clogging is limited.
Dr. Gina said that patients often have several misconceptions about the treatment of shock waves. The biggest misunderstanding is that they think the treatment will "shake off" the arterial plaque and embolize the blood vessels. In fact, although the name carries an 'earthquake' Mechanical wave in the treatment of coronary heart disease, the energy is very low, far less than the intensity of energy in the treatment of extracorporeal lithotripsy Moreover, the role of the site is the myocardium, rather than blood vessels, there is no risk of plaque loss, there is a patient that a shock therapy From the current point of view, the efficacy of a course of treatment for about a year.For patients with strict self-management, the effect will be more lasting.However, if the patient does not Insist on medication, do not pay attention to lifestyle adjustments, blood vessels easily plugged again.
Experts advise, no matter what kind of treatment, coronary heart disease should follow the doctor's advice, life-long take the appropriate drugs, diet should pay attention to low salt, low sugar, low fat, regular exercise, and regular review.
