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增强型体外反搏治疗缺血性心力衰竭患者的临床疗效

Clinical effects of enhanced external counterpulsation treatment in patients with ischemic heart failure.

作者信息

Kozdağ Güliz, Ertaş Gökhan, Aygün Fatih, Emre Ender, Kirbaş Ahu, Ural Dilek, Soran Ozlem

机构信息

Department of Cardiology, Faculty of Medicine, Kocaeli University, Turkey.

出版信息

Anadolu Kardiyol Derg. 2012 May;12(3):214-21. doi: 10.5152/akd.2012.064. Epub 2012 Feb 24.

Abstract

OBJECTIVE

Enhanced external counterpulsation (EECP) is a noninvasive treatment that is proven safe and effective in patients with coronary artery disease (CAD) and heart failure (HF). The aims of this study are to investigate the clinical effects of EECP therapy in patients with symptomatic CAD and chronic HF, and to find out an answer to the question: Does EECP therapy have any effect on the prognostic markers of HF?

METHODS

This study was designed as a prospective cohort study. A total of 68 consecutive patients with symptomatic CAD and chronic HF referred to EECP therapy were enrolled in this study between November 2007 and December 2010; 47 patients (39 males and 8 females, 65 ± 7, years), have undergone EECP treatment, and 21 patients (20 males and 1 female, 62 ± 10 years), who did not want to participate in the EECP program comprised the control group. Statistical analysis was performed using t tests for dependent and independent samples, Mann-Whitney U test, Chi-square and Fischer exact tests.

RESULTS

EECP therapy resulted in significant Improvement in post-intervention New York Heart Association functional class (p<0.001), left ventricular ejection fraction (p<0.001), B-type natriuretic peptide levels (p<0.003), uric acid levels (p<0.05), free-T3/free-T4 ratio (p<0.034) and mitral annular E (p<0.05) velocity, compared with baseline, a finding not evident in the control group.

CONCLUSION

EECP treatment significantly improved clinical and some biochemical parameters, which are mostly prognostic markers in patients with symptomatic CAD and chronic HF.

摘要

目的

增强型体外反搏(EECP)是一种无创治疗方法,已被证明对冠心病(CAD)和心力衰竭(HF)患者安全有效。本研究的目的是探讨EECP治疗对有症状CAD和慢性HF患者的临床效果,并找出以下问题的答案:EECP治疗对HF的预后标志物有影响吗?

方法

本研究设计为前瞻性队列研究。2007年11月至2010年12月期间,共有68例连续转诊接受EECP治疗的有症状CAD和慢性HF患者纳入本研究;47例患者(39例男性和8例女性,65±7岁)接受了EECP治疗,21例患者(20例男性和1例女性,62±10岁)因不想参加EECP项目组成对照组。采用配对t检验、独立样本t检验、Mann-Whitney U检验、卡方检验和Fisher精确检验进行统计学分析。

结果

与基线相比,EECP治疗使干预后纽约心脏协会功能分级(p<0.001)、左心室射血分数(p<0.001)、B型利钠肽水平(p<0.003)、尿酸水平(p<0.05)、游离T3/游离T4比值(p<0.034)和二尖瓣环E峰速度(p<0.05)有显著改善,而对照组未出现此结果。

结论

EECP治疗显著改善了临床和一些生化参数,这些参数大多是有症状CAD和慢性HF患者的预后标志物。

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