Faculty Member Islamic Azad University- Tabriz Branch Tabriz, Azarbayjan-e Sharqi, Iran
Background: The endothelium has a central role in the regulation of blood flow and pressure through continuous modulation of vascular tone. This is primarily accomplished by timely and balanced production and release of nitric oxide (NO).
Aims: The aim of this study was to evaluate the effect of shock wave therapy on endothelial dysfunction.
Methods: Briefly, New Zealand white rabbits underwent balloon dilatation injury at the right carotid artery. Then arteries of the treatment group at lesion region, treated using catheter- based intracorporeal electrohydraulic low- level focused shock wave (12 Kv, 0.3 Hz, 120 Impulses) therapy accompanied by intravenous high- dose lovastatin (5mg/kg/day)- loaded PESDA (Perfluorocarbon Exposed Sonicated Dextrose Albumin) microbubbles administration. In order to evaluate endothelial- dependent relaxation, acetylcholine- mediated dilation (AMD) was measured during the infusion of acetylcholine at a rate of 0.5 μg/kg/min and endothelial independent relaxation was evaluated by measuring nitroglycerin mediated dilation (NMD) during the infusion of nitroglycerin at a rate of 5 μg/kg/min, wherein diagnostic ultrasound is combined with focused shock wave system, with a goal of increased safety.
Results: ultrasonography showed significant differences in AMD between the treated and the non- treated rabbits (p < 0.05), whereas there were no significant differences in NMD between the treatment and normal groups (p>0.05). Also, results from histopathology showed a significant reduction in the mean value for macrophages density within the lesion in the treatment group compared with the non- treatment group (p < 0.05). No microscopic intimal lesions were seen in the normal and treated rabbits, but intimal thickening was observed in the histological studies in the non- treated rabbits.
Conclusion(s): The enhanced anti- inflammatory effect of lovastatin- induced by sonoporation effect of shock wave and collapsed microbubbles plus anti- inflammatory effect of shock wave, can cause to reduce the macrophages density and improve endothelial dysfunction via increasing endothelial nitric oxide synthase.
