Extracorporeal low-energy cardiac shock wave therapy exerts beneficial anti-inflammatory effects on left ventricular remodeling after acute myocardial infarction in rats in vivo

Background: We have previously demonstrated that extracorporeal low-energy shock wave (SW) therapy ameliorates left ventricular (LV) remodeling through enhanced angiogenesis after acute myocardial infarction (AMI) in pigs in vivo. However, it is unclear whether the SW therapy also exerts anti-inflammatory effects on AMI.Methods and results: After AMI was created by coronary ligation, rats were randomly assigned to the 2 groups with or without the SW therapy (1, 3 and 5 days after AMI). The SW therapy ameliorated LV remodeling and fibrosis at 4 weeks after AMI. The SW therapy suppressed the infiltration of neutrophils and macrophages early after AMI, in addition to angiogenesis. The SW therapy also enhanced the expression of eNOS and suppressed the infiltration of TGF-β1-positive cells and pro-inflammatory cytokines. Conclusions: These results suggest that the low-energy SW therapy exerts beneficial effects on LV remodeling after AMI through anti-inflammatory effects in addition to its angiogenic effects.