Ultrasound waves to help an ailing heart

Little-Known Device Uses Non-Invasive Methods To Increase Blood Flow To The HeartMumbai: At a time when ultrasound technology is being reviled as a tool for sex determination, doctors have brought to town a device that uses ultrasound waves to increase blood flow to an ailing heart. Called the Extracorporeal Shockwaves Myocardial Revascularization or ESMR, the machine has been in Mumbai for a month, but few even among the medical community, are aware of it. "It's new technology that is still to be tested to its full potential,'' said a senior cardiologist. 

    But heart surgeon Dr Zainlabedin Hamdulay, who bought this machine in his Bandra clinic, is convinced that ESMR has a place in the bouquet of treatments available for the heart. "It is a non-invasive therapy to boost angiogenesis or development of new blood vessels,'' he said. The logic seems simple enough: It uses sound waves to deliver gentle shocks at a site on the heart that is most likely to develop capillaries. In nine sittings costing Rs 1.5 lakh, patients should develop new capillaries providing extra blood to weakened heart muscles. "The heart's pumping function would thus improve and the patient would feel better,'' said Dr R Merchant, preventive cardiologist with Hamdulay. 
    Can ESMR be qualified as an ultrasound device? Dr Hemant Deshpande, who heads the teaching hospital KEM Hospital's radiology department, makes a distinction: "ESMR uses ultrasound as a guiding technique to deliver sound waves. So, it does qualify as a use of ultrasound, but it's mainly sound waves that are meant to create new blood vessels.'' 
    According to Dr Ashwin Mehta, head of cardiology at Jaslok Hospital, ESRM seems to be one of the many technologies to boost circulation of blood around heart. "But it is not yet a widely studied proposition. There is a large ongoing study in Germany, which will end this year.'' Another cardiologist said there had been several such technologies that have been tried out but faded. "There was a largescale trail using lasers, but it was given up when doctors realized there was no appreciable change. Nowadays, some centres offer stem cell injections as a complementary therapy,'' he said. 
    Hamdulay offers it as an option for patients who are too weak to either undergo a bypass surgery or even an angioplasty. "For years, we have been using an Enhanced External Counter Pulsation (EECP)—a pain-free therapy that promotes a natural bypass to blocked vessels. ESMR is another option for patients who don't want surgery.'' 
DOCS DIVIDED OVER THE POWER OF ESMR 
HOW IT WORKS 
It uses shock waves (like ultrasound) with high intensity and short duration. A form of this technology is used to break kidney stones 
The sound waves are generated by an underwater high-voltage spark, which is delivered non- invasively, focused by a special reflector 
The reflector's focal distance into the patient's body is adjusted after doing a PET (positron emission tomography) Scan to find which part of the heart's muscles are still working 
USES OF ULTRASOUND 
    Routinely used to check patients for gall stones To get image of organs such as the pancreas, aorta, inferior vena cava, liver, gall bladder, bile ducts, kidneys, and the spleen 
    Can be used for foetal scans. Can locate bleeds as well as flow of blood into brain arteries, etc Pelvic sonogram can point out an anomaly in the uterus, ovaries or urinary bladder Can be used to locate possible obstruction of arteries, diagnose DVT (deep vein thrombosis) Used in some forms of liposuction A version of ultrasound can break kidney stones