Acute Hemodynamic Effects and Angina Improvement with Enhanced External Counterpulsation
| Autor: | Tomasz Stys, Peter F. Cohn, John P. Liuzzo, Gudrun Lang, William Lawson, John C.K. Hui |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
Adult
Male medicine.medical_specialty Hemodynamics Subgroup analysis 030204 cardiovascular system & hematology Severity of Illness Index Enhanced external counterpulsation Angina Pectoris Coronary artery disease Angina 03 medical and health sciences Sex Factors 0302 clinical medicine Counterpulsation Internal medicine medicine Humans In patient Prospective Studies 030212 general & internal medicine Hemodynamic effects Aged Aged 80 and over business.industry Age Factors Canadian Cardiovascular Society Middle Aged medicine.disease Surgery Plethysmography Treatment Outcome Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Angiology. 52:653-658 |
| ISSN: | 1940-1574 0003-3197 |
| DOI: | 10.1177/000331970105201001 |
| Popis: | Enhanced external counterpulsation (EECP) is an effective noninvasive treatment for coronary artery disease. The mechanism of action is felt to be hemodynamic. The complex hemody namic effects have been simply quantified by calculating a previously described effectiveness ratio (ER). The EECP Clinical Consortium, a clinical registry of 37 centers, prospectively enrolled 395 chronic stable angina patients (79 women, 316 men, mean age 66 years) to examine the relation of the ER to posttreatment improvement in Canadian Cardiovascular Society angina class (CCS). Women and the elderly underwent planned subgroup analysis. The ER was calcu lated during the first and last hours of a 35-hour course of EECP treatment. After EECP, CCS improved by at least 1 class in 88% of patients, 87% of men and 92% of women (p = NS), and in 89% of patients ≤ 66 years and 88% of patients > 66 years old (p = NS). The initial and final ER were similar in patients with and without improvement in CCS. Significant first-hour ER differences were seen between men and women (0.96 ±0.03 vs 0.76 ±0.04, p < 0.005), and between ages ≤ 66 and > 66 years old (1.04 ±0.04 vs 0.81 ±0.03, p < 0.0001). However, all subgroups responded equally well to EECP treatment. EECP is effective in improving CCS in chronic stable angina patients; it has comparable effects in men and women and across a broad range of ages. The hemodynamic effect of EECP (ER) does not predict improvement in CCS and may indicate that other factors, such as neuro- hormonal changes, may have a significant role in mediating the observed EECP benefits. |
| Databáze: | OpenAIRE |
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