Blast of sound can heal a dicky ticker

SOUNDWAVES could be a new way to treat angina, a painful heart condition. Angina is caused by a partial blockage of blood vessels supplying the heart. Typically, it occurs when someone with the condition is being physically active and more blood needs to be pumped around the body.

As a result they suffer angina pain in the chest — caused by the heart having to work harder than normal. If the blood vessels block completely then this brings on a heart attack.

It is estimated that one in seven men and one in 12 women over 65 have angina. There are treatments available including glyceryl trinitrate sprays to provide immediate relief from symptoms by opening up the blood vessels, but these do not work for all.

Small metal coils called stents can be used to open up narrowed arteries, but these can fail over time and lead to clots. Bypass surgery is another option — where blood is re-routed around the blocked or narrowed section of artery.

The new device could help the tens of thousands who do not respond to medication or are too ill for surgery.

The idea behind it is that firing thousands of energy waves may help improve blood flow by creating new blood vessels in and around the diseased heart.

The painless treatment, similar to that already used to break up kidney stones, has shown good results so far for angina patients. Early small trials have found those who had the treatment had fewer symptoms, were better able to exercise and needed less medication.

Now bigger trials are under way exploring just how effective the treatment can be i n almost 200 patients.

The device looks like a large torch and is placed over the chest above the damaged area of the heart where the blockage or reduced blood flow is — this will have been identified using an ultrasound scan.

The machine is then switched on and fires bursts of high energy sound waves — known as extracorporeal shockwave technology.

It is thought that energy from the waves triggers an increase in chemicals known as growth factors, which stimulate the development of new blood vessels — that can then improve blood supply to the heart, making an angina attack less likely.

The shockwave treatment is also thought to increase levels of nitric oxide, which makes blood vessels di l at e and i mproves bl ood flow further.

So far no significant side-effects from the treatment have been noted and it can be carried out without any anaesthetic as an out- patient procedure.

A previous trial involving 43 angina patients at the University Hospital of Turin in Italy, who had shockwave treatment or a placebo, found those having real treatment were a third less likely to be readmitted to hospital f or angina and needed l ess medica

tion. Another study involving 15 angina patients at the Mayo Clinic in the US showed that the device led to a 38 per cent increase in the time patients were able to exercise on a treadmill.

In the new trial, 170 angina patients will have three 20-minute sessions of shockwaves or placebo over ten weeks at centres in Russia, Lithuania and Germany.

DOCTORS will assess improvements in the length of time patients can exercise, as well as taking figures on the number of angina attacks and medication needed per week. Patients will be monitored for six months.

Dr Ranil de Silva, a consultant cardiologist, describes shockwave therapy as ‘an interesting concept’, but said few studies have been done on humans.