SPECIAL SECTIONS: LETTER TO THE EDITOR
Therapeutic transcutaneous ultrasound: long overdue therapy
Nicholas Kipshidze, MD, PhDa and
Nodar N. Kipshidze, MD, PhDb
a Lenox Hill Heart and Vascular Institute, 130 East 77th Street, Black Hall, 9th Floor, New York, NY 10021, USA
b National Center for Therapy, Tbilisi, Republic of Georgia
nkipshidze{at}lenoxhill.net
The recent report by Miyamoto et al. (1) presents the results of an experimental study evaluating the coronary vessel dilatory effect of transcutaneous low-frequency ultrasound. The investigators used a quite sophisticated animal model and demonstrated by various means that transcutaneous ultrasound induces vasodilation in canine coronary arteries. The magnitude of the effect was similar to that found with intracoronary nitrates. The researchers very correctly concluded that this phenomenon may be used as a therapeutic tool to reduce myocardial ischemia in patients with acute coronary syndromes.
Interestingly, in 1980 we first performed experimental and later clinical studies using approximately similar doses of transcutaneous ultrasound. The ultrasound frequency in our study was 790 to 910 kHz, with the ultrasound of 0.2 to 0.45 W/cm2. The first case of transcutaneous ultrasound therapy in a patient was performed in early 1981 and later published in a USSR patent (2).
We completely agree with the editorial comments of Drs. McPherson and Holland (3) who postulated that this effect of ultrasound is strictly mechanical (acoustic radiation, streaming, and cavitation). Recently, we demonstrated that similar effects can be achieved with other forms of electromagnetic radiation (4,5).
In conclusion, we want to congratulate the investigators on a very interesting study, and we believe that further preclinical and clinical data may prove the safety and efficacy of this long overdue form of therapy, namely transcutaneous therapeutic ultrasound for treatment of ischemia.
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References
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1. Miyamoto T, Neuman Y, Luo H, et al. Coronary vasodilation by noninvasive transcutaneous ultrasound. J Am Coll Cardiol. 2003;41:1623–1627[Abstract/Free Full Text]
2. Kipshidze NN, Chapidze G, Shperling LV, et al. USSR patent no. 1172554: method for the treatment of patients with acute myocardial ischemia. January 18, 1982
3. McPherson DD, Holland CK. Seizing the science of ultrasound: beyond imaging and into physiology and therapeutics. J Am Coll Cardiol. 2003;41:1628–1630[Free Full Text]
4. Kipshidze N, Keelan MH, Petersen JR, et al. Photoactivation of vascular iNOS and elevation of cGMP in vivo: possible mechanism for photovasorelaxation and inhibition of restenosis in an atherosclerotic rabbit model. Photochem Photobiol. 2000;72:579–582[Medline]
5. Kipshidze N, Nikolaychik V, Keelan MH, et al. Low-power helium: neon laser irradiation enhances production of vascular endothelial growth factor and promotes growth of endothelial cells in vitro. Lasers Surg Med. 2001;28:355–364[Medline]
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