LONG-TERM EFFECTIVENESS OF ENHANCED EXTERNAL COUNTERPULSATION IN PATIENTS WITH ISCHEMIC CHRONIC HEART FAILURE

Abstract

Aim. To study the long-term effect of complex therapy with the addition of enhanced external counterpulsation (EECP) on exercise tolerance, quality of life and systolic heart function in patients with ischemic chronic heart failure (CHF). Material and methods. Patients with ischemic CHF NYHA class II-III (n=20) included in the study. Patients, in addition to optimal medical therapy, were treated with EECP (35 hours, the standard protocol, 1 course every 6 months). The duration of observation was 5 years. Baseline, 12, 24, 36, 48 and 60 months performed assessment of NT-proBNP level, clinical status, exercise tolerance (6-minute walk test – 6MWT), quality of life (Minnesota Living with Heart Failure Questionnaire – MLHFQ), left ventricular ejection fraction (LVEF) according to echocardiography. The composite primary endpoint (CPE) included adverse cardiovascular events, new cases of atrial fibrillation (AF), diabetes mellitus (DM), decreased renal function, and hospitalizations due to CHF. Results. During the observation period (60 months), significant stable positive dynamics were noted in exercise tolerance (6MWT distance increased by 59.3%), clinical status, LVEF, NT-proBNP level, quality of life (MLHFQ). The incidence of myocardial infarction was 5%, revascularization – 15%, new cases of AF – 5%, decreased renal function – 10%, hospitalizations for CHF – 35%. There were no cases of strokes, deaths or new cases of diabetes. The prevalence of CPE was 70% over a 5-year period. Conclusion. A stable positive effect of EECP treatment of patients with ischemic heart failure on functional status and clinical outcomes has been demonstrated.