Enhanced External Counterpulsation for the Treatment of Angina With Nonobstructive Coronary Artery Disease.

Autor: Ashokprabhu ND; Women's Heart Center, The Christ Hospital Heart and Vascular Institute, Cincinnati, Ohio; The Carl and Edyth Lindner Center for Research and Education at The Christ Hospital, Cincinnati, Ohio., Fox J; Flow Therapy, Fort Worth, Texas; Thomas J Long School of Pharmacy, University of the Pacific, Stockton, California., Henry TD; Women's Heart Center, The Christ Hospital Heart and Vascular Institute, Cincinnati, Ohio; The Carl and Edyth Lindner Center for Research and Education at The Christ Hospital, Cincinnati, Ohio., Schmidt CW; The Carl and Edyth Lindner Center for Research and Education at The Christ Hospital, Cincinnati, Ohio., Tierney D; Women's Heart Center, The Christ Hospital Heart and Vascular Institute, Cincinnati, Ohio., Gallatin J; Women's Heart Center, The Christ Hospital Heart and Vascular Institute, Cincinnati, Ohio., Alvarez YR; Women's Heart Center, The Christ Hospital Heart and Vascular Institute, Cincinnati, Ohio; The Carl and Edyth Lindner Center for Research and Education at The Christ Hospital, Cincinnati, Ohio., Thompson L; Women's Heart Center, The Christ Hospital Heart and Vascular Institute, Cincinnati, Ohio., Hamstra M; Women's Heart Center, The Christ Hospital Heart and Vascular Institute, Cincinnati, Ohio., Shah SA; Flow Therapy, Fort Worth, Texas; Thomas J Long School of Pharmacy, University of the Pacific, Stockton, California., Quesada O; Women's Heart Center, The Christ Hospital Heart and Vascular Institute, Cincinnati, Ohio; The Carl and Edyth Lindner Center for Research and Education at The Christ Hospital, Cincinnati, Ohio; Department of Medicine, University of Cincinnati, Cincinnati, Ohio. Electronic address: odayme.quesada@thechristhospital.com.
Jazyk: angličtina
Zdroj: The American journal of cardiology [Am J Cardiol] 2024 Jan 15; Vol. 211, pp. 89-93. Date of Electronic Publication: 2023 Oct 27.
DOI: 10.1016/j.amjcard.2023.10.061
Abstrakt: Angina and nonobstructive coronary artery disease (ANOCA) is associated with poor outcomes and limited treatment options. Enhanced external counterpulsation (EECP) is a noninvasive treatment that involves applying external inflatable cuffs to the lower extremities to increase blood flow during diastole, followed by deflation during systole. Although EECP is approved for treatment in patients with refractory angina due to obstructive coronary artery disease, its effectiveness in treating patients with ANOCA with refractory angina is limited to small studies. We assessed the efficacy of EECP treatment in patients with ANOCA (defined as ≤50% stenosis in any major epicardial vessels) with refractory anginaby measuring changes in Canadian Cardiovascular Society (CCS) angina class, 6-minute walk test, Duke Activity Status Index (DASI), Seattle Angina Questionnaire 7 (SAQ7), and weekly anginal episodes pre-EECP and post-EECP treatment. A total of 101 patients with ANOCA with CCS class III/IV angina completed a full course of EECP treatment at 2 large EECP centers. In 101 patients with ANOCA the mean age (SD) of 60.6 (11.3) years and 62.4% of the cohort were women. We found significant improvements post-EECP treatment in CCS angina class (mean (SD) 3.4 (0.5) to 2.4 (2.9), p <0.001), 6-minute walk test (median 1200 (IQR 972 to 1411) to 1358 (1170 to 1600), p <0.001), DASI (mean (SD) 15.2 (11.6) to 31.5 (16.3), p <0.001), SAQ7 (mean (DS) 36.2 (24.7) to 31.5 (16.3), p <0.001), and weekly anginal episodes (mean (SD) 5.3 (3.5) to 2.4 (2.9), p <0.001). After EECP treatment, 71 patients (70.3%) had an improvement of ≥1 CCS angina class, including 33 (32.7%) patients improving by ≥2 CCS classes. In conclusion, in patients with ANOCA, EECP therapy reduces CCS angina class and improves exercise tolerance and capacity; and should be considered a part of optimal medical therapy.
Competing Interests: Declaration of Competing Interest Dr. Quesada reports financial support from the National Institutes of Health. The remaining authors have no competing interest to declare.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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