This study is the first randomized, sham-controlled trial to evaluate the effects of direct cardiac shockwave therapy (SWT) combined with coronary artery bypass graft surgery (CABG) in patients with reduced left ventricular function undergoing surgical revascularization. During the procedure, shockwaves were applied directly to the ischemic myocardium identified by preoperative cardiac MRI. The trial (CAST-HF; NCT03859466) involved patients with left ventricular ejection fraction (LVEF) ≤40%, who were randomly assigned to receive either direct cardiac SWT or a sham treatment in addition to CABG. The primary efficacy endpoint was the improvement in LVEF measured by cardiac MRI from baseline to 360 days.

The study included 63 patients, with 30 in the SWT group and 28 in the sham group completing the 1-year follow-up. Results showed a greater improvement in LVEF for the SWT group (Δ from baseline to 360 days: SWT 11.3%, SD 8.8; sham 6.3%, SD 7.4, p = 0.0146). The study concluded that direct cardiac SWT combined with CABG significantly improves LVEF and physical capacity in patients with ischemic heart failure, with no reported safety concerns.

Reference: Ahmed B. Cardiac Shockwave Therapy Plus CABG for Ischemic HF. American College of Cardiology. Published July 11, 2024. Accessed July 19, 2024. https://www.acc.org/Latest-in-Cardiology/Journal-Scans/2024/07/11/16/29/cardiac-shockwave-therapy