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

被引:4
|
作者
Ashokprabhu, Namrita D. [1 ,2 ]
Fox, Jessie [3 ,4 ]
Henry, Timothy D. [1 ,2 ]
Schmidt, Christian W. [2 ]
Tierney, Darlene [1 ]
Gallatin, Julie [1 ]
Alvarez, Yulith Roca [1 ,2 ]
Thompson, Lauren [1 ]
Hamstra, Michelle [1 ]
Shah, Sachin A. [3 ,4 ]
Quesada, Odayme [1 ,2 ,5 ]
机构
[1] Christ Hosp Heart & Vasc Inst, Womens Heart Ctr, Cincinnati, OH 45219 USA
[2] Christ Hosp, Carl & Edyth Lindner Ctr Res & Educ, Cincinnati, OH 45219 USA
[3] Flow Therapy, Ft Worth, TX USA
[4] Univ Pacific, Thomas J Long Sch Pharm, Stockton, CA USA
[5] Univ Cincinnati, Dept Med, Cincinnati, OH 45221 USA
来源
AMERICAN JOURNAL OF CARDIOLOGY | 2024年 / 211卷
基金
美国国家卫生研究院;
关键词
angina and nonobstructive coronary artery disease; ANOCA; coronary microvascu-lar dysfunction; EECP; enhanced external counter pulsation; ACTIVITY STATUS INDEX; MICROVASCULAR DYSFUNCTION; HEART-DISEASE; ISCHEMIA; FLOW;
D O I
10.1016/j.amjcard.2023.10.061
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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(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. (c) 2023 Elsevier Inc. All rights reserved.
引用
收藏
页码:89 / 93
页数:5
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