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Original Article
Significant Improvement in Functional Status and Quality of Life in Heart Failure Patients who Received EECP
Volume 2, Jan 2013
Nitu Kataria, MD, Sanjay Mittal MD, DM, Ravi R Kasliwal MD, DM, Naresh Trehan MD, Gurgaon, India
Purpose: EECP therapy has been studied in refractory ischemic cardiomyopathy and heart failure patients with good results in the past. However, the mechanism and potential indications remain unexplored.
Methods: We did a retrospective analysis of defined end points in 60 heart failure patients who received EECP therapy at our center. Commonest indication of EECP therapy was significant diffuse coronary artery disease in patients who were not candidates for any revascularization therapy (95%) and continued to have symptoms despite maximal tolerated medical therapy. Majority of the patients were NYHA class III with mean age 64 years. The EECP therapy included daily sessions of 1-hour duration for 35 days. The Canadian Cardiovascular Society (CCS) angina class and the Medical Research Council (MRC) breathlessness scale were used to study improvement in symptoms. Quality of life indicators were (a) reduction in symptoms (b) improvement in activity (c) improvement in psychological parameters. The objective parameters studied were ejection fraction and 6-minute walk distance.
Results: There was a significant improvement in all study parameters after EECP therapy (Table 1).
Conclusions: EECP therapy is an excellent treatment option for heart failure patients who are at the end of the road in terms of medical and interventional therapies. Our hypothesis is that EECP therapy works not only through a mechanism of improved collateral circulation but also improves endothelial function with potential benefit in all vascular pathologies. Large randomized trials to validate the hypothesis are proposed. (J Clin Prev Cardiol 2013;2(1):8-16)
Volume 2, Number 1, Pages: 8-16
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