增强型体外反搏术结果研究:对美国一家医疗中心患者数据的回顾性分析

Ashok Akula, Heidi R. Grafft, Nadia Tak, Douglas A. Haberman, Tahir Tak
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摘要

目的是探讨增强体外反搏(EECP)疗法对不适合接受侵入性治疗的严重心绞痛/慢性心力衰竭患者的疗效。这项回顾性研究采用了一种综合方法,包括个性化治疗、持续监测和全面的计划前后评估,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。对治疗前后的结果进行分析后发现,与治疗前相比,EECP 改善了原有的功能分级。功能分级的平均差异为 1.32 (0.92),P < 0.0001。六分钟步行(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)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 (MET) 从 3.0 (0.74) 提高到 4.0 (1.57),平均差异为 1.04 (1.2),P < 0.0001。每周心绞痛事件从 13.1 (13.19) 下降到 3.2 (7.38),平均差异为 -9.78 (11.7),p < 0.0001。EECP 改善了心绞痛的功能分级和 6MW 距离,减少了治疗后第一年的住院次数,显著减少了舌下含服硝酸甘油的次数,改善了收缩压和舒张压,并改善了 DASI 评分。
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Enhanced External Counterpulsation Outcomes Study: Retrospective Analyses of Data Obtained from Patients at a Single Medical Center in United States
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), p < 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), p < 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), p < 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), p < 0.0001. Weekly anginal events decreased from 13.1 (13.19) to 3.2 (7.38) with mean difference of –9.78 (11.7), p < 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.
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