Enhanced External Counterpulsation Improves Exercise Tolerance in Patients With Chronic Heart Failure

Feldman, Arthur M.; Silver, Marc A.; Francis, Gary S.; Abbottsmith, Charles W.; Fleishman, Bruce; Soran, Özlem; Lame, Paul-Andre de; Varricchione, Thomas

doi:10.1016/j.jacc.2005.10.079

Cited by 69 publications

(50 citation statements)

References 16 publications

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“…Previous studies showed that improvement in NYHA class has been associated with a favorable prognosis (22,23). It has been shown that EECP treatment improved symptoms and functional capacity in patients with or without systolic HF (19)(20)(21) therapy (25). The results of our study supported previous studies findings because NYHA class was improved as above mentioned studies.…”

Section: Discussionsupporting

confidence: 91%

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

Kozdağ¹,

Ertaş²,

Aygün³

et al. 2012

Anadolu Kardiyol Derg

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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. (Anadolu Kardiyol Derg 2012; 12: 214-21)

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Section: Discussionsupporting

confidence: 91%

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

Kozdağ¹,

Ertaş²,

Aygün³

et al. 2012

Anadolu Kardiyol Derg

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“…Nevertheless, EECP can improve symptom, QOL, and exercise tolerance in patients with left ventricular systolic dysfunction and angina, and/or HF. 17,18 The natural history of chronic refractory angina has not been well described, and whether or not EECP can alter its clinical course is unclear. In a preliminary report from a randomized controlled trial, the addition of EECP to optimal medical therapy reduces the mortality and MI rates in patients with CAD.…”

Section: Discussionmentioning

confidence: 99%

Enhanced External Counterpulsation in the Treatment of Chronic Refractory Angina: A Long‐term Follow‐up Outcome from the International Enhanced External Counterpulsation Patient Registry

Loh

Cleland

Louis

et al. 2008

Clinical Cardiology

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BackgroundThe management of patients who suffer from medically refractory angina and are unsuitable for conventional revascularization therapy is often unsatisfactory. Enhanced external counterpulsation (EECP) is a noninvasive treatment that is safe and effective immediately after a course of treatment. However, the duration of benefit is less certain.HypothesisTo evaluate the 3‐year outcome of EECP treatment.MethodsOne thousand four hundred and twenty seven patients from 36 centers registered in the International EECP Patient Registry (IEPR)—Phase 1 was prospectively followed for a median of 37 months. Two hundred and twenty patients (15.4%) died, while 1,061 patients (74.4%) completed their follow‐up.ResultsThe mean age was 66 ± 11 years and 72% were men. Seventy‐six percent had multivessel coronary disease for 11 ± 8 years. Eighty‐eight percent had a prior percutaneous or surgical revascularization and 82% were unsuitable for further coronary intervention.Immediately post‐EECP, the proportion of patients with severe angina (Canadian Cardiovascular Angina Classification [CCS] III/IV) were reduced from 89% to 25%, p<0.001. The CCS class was improved by at least 1 class in 78% of the patients and by at least 2 classes in 38%. This was sustained in 74% of the patients during follow‐up.Thirty‐six percent of the patients had CCS II or less angina, which was better than pre‐EECP state without a major adverse cardiovascular event during follow‐up. More severe baseline angina and a history of heart failure or diabetes were independent predictors of unfavorable outcome.ConclusionAn EECP improves angina and quality of life immediately after a course of treatment. For most of the patients, these beneficial effects are sustained for 3 years. Copyright © 2008 Wiley Periodicals, Inc.

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“…Of note, 11.4% and 14.3% of placebo patients reported the same results, respectively. 21 Improvements in quality-of-life assessments without any major complications have also been demonstrated at 1 week and 6 months after EECP. In a study of 450 patients with refractory angina and left ventricular dysfunction (ejection fraction [EF]< 30 ± 8%) EECP significantly reduced 6-month emergency room visits by 78% and hospitalizations by 73%.…”

Section: Role Of Eecp In Congestive Heart Failurementioning

confidence: 91%

“…This may have been attributed to low patient numbers and non-blinding of patients to therapy, hence leading to a placebo effect. 21 Some data from IEPR reveal that in patients with EF < 35% there is a significant increase in adverse cardiac events, death, congestive heart failure, and hospitalization after 6 months. 19 Non-randomized trials conducted with limited patients and at a limited number of institutions usually run the risk of selection bias and placebo effect influencing the outcome of the trial.…”

Section: Controversiesmentioning

confidence: 99%

The Role of Enhanced External Counter Pulsation Therapy in Clinical Practice

Sharma

Ramsey

Tak

2013

Clinical Medicine & Research

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Enhanced External Counterpulsation Improves Exercise Tolerance in Patients With Chronic Heart Failure

Abstract: In this randomized, single-blinded study, EECP improved exercise tolerance, quality of life, and NYHA functional classification without an accompanying increase in peak VO2.

Cited by 69 publications

References 16 publications

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

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

Enhanced External Counterpulsation in the Treatment of Chronic Refractory Angina: A Long‐term Follow‐up Outcome from the International Enhanced External Counterpulsation Patient Registry

The Role of Enhanced External Counter Pulsation Therapy in Clinical Practice

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