الفهرس 
Title : Echocardiographic assessment of the left ventricular function in patients with chronic systolic heart failure before and after low level laser physiotherapy
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Abstract
Background: chronic left ventricular systolic heart failure isa common disease affecting the quality of life especially if the patient is not fit for revascularization or resynchronization. Low level laser therapy (LLL) is apromising noninvasive physiotherapeutic modality that may improve quality of life for those patients giving them hope for a better life. Aim of the study:to study the effect of LLL therapy on patients with chronic systolic heart failure on optimal medical therapy regarding clinical condition by six minute walk test(6MWT) and NYHA functional classification and left ventricular functions by echocardiography as well as measurement of serum nitric oxide level(NO). Patients and methods: 27patients with chronic left ventricular systolic heart failure on optimized medical therapy 2 months before the study.Laser probe was placed on intercostal space on certain points anteriorly and posteriorly on chest wall and arm with standardized laser acupuncture points of application3sessions per week for 10 sessions,(blood samples for serum NOmeasurementwithdrawn, echocardiography was done) one day before and after the course of laser therapy. Results:The mean age was 58 years, 77.78% (no=21) of our patients were males. In our study the NYHA classification significantly improved as well as 6MWT after LLL therapy, regarding NYHA classification 15 patients were in class III ,12 were in class IV, no one was in class II before LLLtherapy while after laser therapy; 25 patients shifted to class II,two patients were in class III with P value<0.001* denoting a highly significant clinical improvement, Our second clinical parameter was the 6MWT revealed: the mean was less than 200 meters before the study that changed to more than 300 after laser therapy(385.074±61.740) with significant P-value