Akula Ashok, Grafft Heidi R, Tak Nadia, Haberman Douglas A, Tak Tahir
Department of Internal Medicine and Cardiac Rehab, Mayo Clinic Health System - Southwest Wisconsin Region, La Crosse, Wisconsin.
University of Minnesota - Twin Cities, Minneapolis, MN.
Int J Angiol. 2024 Mar 30;33(3):182-188. doi: 10.1055/s-0044-1782657. eCollection 2024 Sep.
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.
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。
