Andrew Hoffmann and Harjit Gill
Coronary artery disease (CAD) is a leading source of death and morbidity, and the search continues for viable therapeutic options to stimulate new coronary growth. Low frequency vibration (LFV) can induce fluid sheer forces and cyclic stretch/strain to vascular endothelial cells and extracellular matrix which is known to up-regulate expression of pro-angiogenic mediators such as nitric oxide, vascular endothelial growth factor, and other sheer responsive proteins. Further, cyclic stretch of coronary microvascular cells has shown to induce coronary angiogenesis in-vitro, and LFV promoted arteriogenesis has recently been demonstrated in-vivo. Interestingly there has been no work to address whether transthoracic LFV massage could induce neo-coronary growth in CAD patients. We therefore present a single center, prospective, blinded, randomized, controlled pilot study protocol aiming to test whether penetrative LFV (35 Hz) applied to the upper back of refractory angina (RFA) and/or ischemic heart failure (IHF) patients (by daily 30 minute sessions, over a 3 month period) may enhance lasting myocardial perfusion and improve clinical outcomes.