J Cardiovasc Nurs. 2020 Jul/Aug;35(4):375-385. doi: 10.1097/JCN.0000000000000638.
Patients with refractory angina pectoris experience recurrent symptoms that limit their functional capacity, including psychological distress and impaired health-related quality of life (HRQoL), despite optimized medical therapy. Enhanced external counterpulsation (EECP) is an evidence-based alternative noninvasive treatment. Although physical well-being and mental well-being are equally important components of health, few studies have investigated the psychological effects of EECP in patients with refractory angina pectoris.
The aim of this study was to evaluate the effects of EECP treatment in patients with refractory angina pectoris regarding medication profile, physical capacity, cardiac anxiety, and HRQoL.
This quasi-experimental study with 1-group pretest-posttest design includes a 6-month follow-up of 50 patients (men, n = 37; mean age, 65.8 years) who had undergone 1 EECP course. The following pretreatment and posttreatment data were collected: medication use, 6-minute walk test results, functional class according to the Canadian Cardiovascular Society, and self-reported (ie, questionnaire data) cardiac anxiety and HRQoL. In addition, the questionnaires were also completed at a 6-month follow-up.
After EECP treatment, patients used significantly less nitrates (P < .001), walking distance increased on average by 46 m (P < .001), and Canadian Cardiovascular Society class improved (P < .001). In addition, all but 1 subscale of cardiac anxiety and all HRQoL components improved significantly (P < .05). The positive effects for cardiac anxiety and HRQoL were maintained at the 6-month follow-up.
Enhanced external counterpulsation treatment resulted in reduced symptom burden, improved physical capacity, and less cardiac anxiety, leading to increased physical activity and enhanced life satisfaction for patients with refractory angina pectoris. Enhanced external counterpulsation treatment should be considered to improve the life situation for these patients.
尽管经过了优化的药物治疗，患有难治性心绞痛的患者仍会经历反复发作的症状，限制其功能能力，包括心理困扰和健康相关生活质量（HRQoL）受损。增强型体外反搏（EECP）是一种基于证据的非侵入性替代治疗方法。尽管身体和心理健康都是健康的同等重要组成部分，但很少有研究调查 EECP 对难治性心绞痛患者的心理影响。
本研究旨在评估 EECP 治疗对难治性心绞痛患者药物治疗方案、身体能力、心脏焦虑和 HRQoL 的影响。
这是一项具有 1 组前后测试设计的准实验研究，对 50 名（男性，n=37；平均年龄 65.8 岁）接受 1 次 EECP 疗程的患者进行了 6 个月的随访。收集了以下治疗前和治疗后的数据：药物使用、6 分钟步行测试结果、加拿大心血管学会功能分类和自我报告（即问卷数据）的心脏焦虑和 HRQoL。此外，问卷也在 6 个月的随访时完成。
EECP 治疗后，患者使用的硝酸盐显著减少（P<.001），平均步行距离增加了 46 米（P<.001），加拿大心血管学会功能分类改善（P<.001）。此外，除 1 个心脏焦虑亚量表和所有 HRQoL 成分外，其余量表均显著改善（P<.05）。心脏焦虑和 HRQoL 的积极影响在 6 个月的随访时得以维持。
增强型体外反搏治疗可减轻症状负担，提高身体能力，减少心脏焦虑，从而增加难治性心绞痛患者的身体活动和提高生活满意度。增强型体外反搏治疗应被考虑用于改善这些患者的生活状况。
