CAST-HF Trial

Cardiac Shockwave Therapy for heart failure

Chronic ischaemic heart failure remains a major challenge as revascularisation strategies relieve symptoms but often fail to restore left ventricular function. Cardiac shockwave therapy (SWT) is a novel therapeutic approach that aims to stimulate angiogenesis and myocardial repair in hibernating myocardium. To investigate this potential, the CAST-HF trial was conducted as a single-blind, parallel-group, sham-controlled study. Patients with left ventricular ejection fraction (LVEF) ≤40% undergoing coronary artery bypass grafting (CABG) were randomly assigned to receive intraoperative direct cardiac SWT or sham treatment in addition to surgery. The primary endpoint was the change in LVEF assessed by cardiac magnetic resonance imaging (CMR) from baseline to 12 months, while functional capacity and quality of life served as secondary endpoints.

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Single-Blind
Parallel-Group
Sham-Controlled
Patients enrolled

63

Trial Date

2021

Follow-Up duration

up to 4 years

Cast HF

Results at 360 Days

  • LVEF: +11.3% (SWT) vs. +6.3% (Sham) (p = .0146)
  • 6-Minute Walk Test: +127.5 m (SWT) vs. +43.6 m (Sham) (p = .028)
  • MLHFQ: Greater quality of life improvements in the SWT group

Results at Long-Term Follow-Up

  • LVEF: +11.5 % (SWT) vs. +2.8 % (Sham) (p = .0009)
  • 6-Minute Walk Test: +62.6 m (SWT) vs. -1.5 m (Sham) (p = .031)
  • MLHFQ: Greater quality of life improvements in the SWT group