Arora R R, Chou T M, Jain D, Fleishman B, Crawford L, McKiernan T, Nesto R W
Columbia-Presbyterian Medical Center, Columbia University, New York, New York, USA.
J Am Coll Cardiol. 1999 Jun;33(7):1833-40. doi: 10.1016/s0735-1097(99)00140-0.
The purpose of this study was to assess safety and efficacy of enhanced external counterpulsation (EECP).
Case series have shown that EECP can improve exercise tolerance, symptoms and myocardial perfusion in stable angina pectoris.
A multicenter, prospective, randomized, blinded, controlled trial was conducted in seven university hospitals in 139 outpatients with angina, documented coronary artery disease (CAD) and positive exercise treadmill test. Patients were given 35 h of active counterpulsation (active CP) or inactive counterpulsation (inactive CP) over a four- to seven-week period. Outcome measures were exercise duration and time to > or =1-mm ST-segment depression, average daily anginal attack count and nitroglycerin usage.
Exercise duration increased in both groups, but the between-group difference was not significant (p > 0.3). Time to > or =1-mm ST-segment depression increased significantly from baseline in active CP compared with inactive CP (p = 0.01). More active-CP patients saw a decrease and fewer experienced an increase in angina episodes as compared with inactive-CP patients (p < 0.05). Nitroglycerin usage decreased in active CP but did not change in the inactive-CP group. The between-group difference was not significant (p > 0.7).
Enhanced external counterpulsation reduces angina and extends time to exercise-induced ischemia in patients with symptomatic CAD. Treatment was relatively well tolerated and free of limiting side effects in most patients.
本研究旨在评估增强型体外反搏（EECP）的安全性和有效性。
病例系列研究表明，EECP可改善稳定型心绞痛患者的运动耐量、症状及心肌灌注。
在7所大学医院开展了一项多中心、前瞻性、随机、双盲、对照试验，纳入139例有胸痛症状、确诊为冠心病（CAD）且运动平板试验阳性的门诊患者。患者在4至7周内接受35小时的主动反搏（active CP）或非主动反搏（inactive CP）治疗。观察指标为运动持续时间、出现≥1毫米ST段压低的时间、每日平均心绞痛发作次数及硝酸甘油使用量。
两组患者的运动持续时间均增加，但组间差异无统计学意义（p>0.3）。与非主动反搏组相比，主动反搏组出现≥1毫米ST段压低的时间较基线水平显著延长（p = 0.01）。与非主动反搏组患者相比，主动反搏组中更多患者的心绞痛发作次数减少，更少患者的发作次数增加（p<0.05）。主动反搏组硝酸甘油使用量减少，而非主动反搏组未改变。组间差异无统计学意义（p>0.7）。
增强型体外反搏可减轻有症状CAD患者的心绞痛症状，并延长运动诱发心肌缺血的时间。大多数患者对该治疗耐受性较好，且无明显副作用。
