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增强型体外反搏疗效研究:对美国一家医疗中心患者数据的回顾性分析

Enhanced External Counterpulsation Outcomes Study: Retrospective Analyses of Data Obtained from Patients at a Single Medical Center in United States.

作者信息

Akula Ashok, Grafft Heidi R, Tak Nadia, Haberman Douglas A, Tak Tahir

机构信息

Department of Internal Medicine and Cardiac Rehab, Mayo Clinic Health System - Southwest Wisconsin Region, La Crosse, Wisconsin.

University of Minnesota - Twin Cities, Minneapolis, MN.

出版信息

Int J Angiol. 2024 Mar 30;33(3):182-188. doi: 10.1055/s-0044-1782657. eCollection 2024 Sep.

Abstract

The aim was to explore the effectiveness of enhanced external counterpulsation (EECP) therapy in patients with severe angina pectoris/ chronic heart failure symptoms, who were not suitable candidates for invasive treatment. This retrospective study employed a comprehensive methodology that includes individualized treatment, continuous monitoring, and thorough pre- and postprogram evaluations to assess the efficacy of EECP therapy. The standard protocol involved 35 one-hour treatments, with flexibility for extensions based on therapeutic progress. When pre- and posttreatment results were analyzed, EECP improved the original functional class compared with pretreatment. The mean difference in the functional class was 1.32 (0.92),  < 0.0001. Six-minute walk (6MW) distance improved from 383.6 m (110.24) to 423.1 m (121.50) with mean difference of 37.1 (44.99),  < 0.0001. Duke Activity Status Index (DASI) score improved from 3.9 (2.75) to 6.0 (4.17) with mean difference of 2.16 (3.8),  < 0.0001. Training metabolic equivalents (METs) improved from 3.0 (0.74) to 4.0 (1.57) with mean difference of 1.04 (1.2),  < 0.0001. Weekly anginal events decreased from 13.1 (13.19) to 3.2 (7.38) with mean difference of -9.78 (11.7),  < 0.0001. EECP resulted in improvement of angina pectoris functional class, the 6MW distance, reduction in the number of hospitalizations in first year posttreatment, a significant decrease in sublingual nitroglycerin use, improvement of systolic and diastolic blood pressure, and improvement of DASI score.

摘要

目的是探讨增强型体外反搏(EECP)疗法对患有严重心绞痛/慢性心力衰竭症状且不适合进行侵入性治疗的患者的有效性。这项回顾性研究采用了综合方法,包括个体化治疗、持续监测以及全面的治疗前和治疗后评估,以评估EECP疗法的疗效。标准方案包括35次一小时的治疗,并可根据治疗进展灵活延长。分析治疗前和治疗后的结果时,与治疗前相比,EECP改善了原来的功能分级。功能分级的平均差异为1.32(0.92),P<0.0001。6分钟步行(6MW)距离从383.6米(110.24)提高到423.1米(121.50),平均差异为37.1(44.99),P<0.0001。杜克活动状态指数(DASI)评分从3.9(2.75)提高到6.0(4.17),平均差异为2.16(3.8),P<0.0001。训练代谢当量(METs)从3.0(0.74)提高到4.0(1.57),平均差异为1.04(1.2),P<0.0001。每周心绞痛发作次数从13.1(13.19)减少到3.2(7.38),平均差异为-9.78(11.7),P<0.0001。EECP可改善心绞痛功能分级、6MW距离,减少治疗后第一年的住院次数,显著减少舌下硝酸甘油的使用,改善收缩压和舒张压,并提高DASI评分。

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