Long-term effects of enhanced external counterpulsation in the management of patients with stable coronary heart disease complicated by heart failure: data from the EXCEL study

Authors: Lishuta A.S., Slepova O.A., Nikolaeva N.A., Privalova E.V., Belenkov Yu.N.

Company: Sechenov First Moscow State Medical University, Moscow, Russian Federation

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Type:  Original articles


DOI: https://doi.org/10.24022/1997-3187-2024-18-2-194-201

For citation: Lishuta A.S., Slepova O.A., Nikolaeva N.A., Privalova E.V., Belenkov Yu.N. Long-term effects of enhanced external counterpulsation in the management of patients with stable coronary heart disease complicated by heart failure: data from the EXCEL study. Creative Cardiology. 2024; 18 (2): 194–201 (in Russ.). DOI: 10.24022/1997-3187-2024-18-2-194-201

Received / Accepted:  09.04.2024 / 22.04.2024

Keywords: enhanced external counterpulsation coronary heart disease chronic heart failure exercise tolerance vascular effects quality of life



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Abstract

Objective. To study the long-term effect of complex therapy with the addition of enhanced external counterpulsation (EECP) on exercise tolerance, quality of life (QOL), systolic heart function in patients with ischemic chronic heart failure (CHF).

Material and methods. Patients with verified ischemic CHF NYHA class II-III with reduced or intermediate left ventricular ejection fraction (LVEF) (n = 118) in the open randomized study EXCEL (NCT05913778) were randomized into group 1 (n = 59) – optimal medical therapy (OMT) and EECP (35 hours, 2 courses per year), group 2 (n = 59) – OMT and EECP (35 hours, 1 course in year). All patients initially, after 12 and 24 months underwent a 6-minute walk test (6MWT), assessment of clinical status, quality of life according to the MLHFQ questionnaire, levels of NT-proBNP, left ventricular ejection fraction (LVEF).

Results. Both groups had positive dynamics in CHF NYHA class (the average class decreased in the 1st group from 2.40 to 1.95, and in the 2nd group from 2.37 to 2.19 after 24 months) and the clinical status of the patients. A significant increase in the distance in 6MWT was found in both groups – in the 1st group the increase after 24 months was 56.6% and in the 2nd group – 33.6%. There was a statistically significant decrease in the score in the MLHFQ questionnaire in the 1st group after 24 months – by 40.5%, and in the 2nd group – by 30.1%, as well as significant increase in LVEF (by 20.7% in group 1 and 8.0% in group 2) and a decrease in NT-proBNP levels (by 51.3% in group 1 and 35.8% in group 2).

Conclusion. Consistent improvements in exercise capacity, quality of life, and a systolic cardiac function were demonstrated over a 24-month study period by the effects of EECP in patients with ischemic CHF.

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About Authors

  • Aleksey S. Lishuta, Cand. Med. Sci., Professor; ORCID
  • Olga A. Slepova, Cand. Med. Sci.; ORCID
  • Nadezhda A. Nikolaeva, Postgraduate; ORCID
  • Elena V. Privalova, Dr. Med. Sci., Professor; ORCID
  • Yuriy N. Belenkov, Dr. Med. Sci., Professor, Academician of the Russian Academy of Medical Sciences, Head of the Department of Hospital Therapy No. 1; ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery