The effects of enhanced external counterpulsation on myocardial perfusion in patients with stable angina: A multicenter radionuclide study
The effects of enhanced external counterpulsation on myocardial perfusion in patients with stable angina: A multicenter radionuclide study
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DOI：
10.1016/j.ahj.2005.01.054
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发表时间：
2005-11-01
影响因子：
4.8
通讯作者：
Beller, G
中科院分区：
文献类型：
--
作者：
Michaels, AD;Raisinghani, A;Beller, G
背景：增强型体外反搏（EECP）可减少有症状冠心病患者的心绞痛，延长运动诱发缺血的时间。单中心和双中心研究以及一项回顾性病例系列报告称，EECP可改善稳定型心绞痛患者的心肌灌注。我们试图严格评估和量化EECP对心肌perfusion.Methods的影响，在6所美国大学医院，EECP进行了35小时的II级至IV级心绞痛患者谁有运动引起的心肌缺血。在基线和EECP后1个月进行症状限制性定量门控锝99 mSestamibi单光子发射计算机断层扫描运动灌注成像。在两次压力测试中，Sestamibi都以一定的心率注射。单光子发射计算机断层扫描图像读取在一个盲核心laborator.Results 37例患者入组，其中34人完成前和后EECP的压力测试。平均年龄为61 ± 10岁，81%为男性，78%既往接受过血运重建，68%有3支血管病变。平均心绞痛分级从基线时的2.7 ± 0.7下降到EECP后的1.7 ± 0.7（P <0.001）。运动持续时间从基线时的9.1 +/- 3.7分钟增加到EECP后的10.2 +/- 3.6分钟（P = 0.03）。示踪剂摄取的平均百分比，可逆性的大小，平均增厚分数，左心室射血分数EECP后保持不变。结论我们证实了以前的报告，EECP减少心绞痛，提高运动能力。在相同的EECP前和后心率下，使用心肌定量单光子发射计算机断层扫描成像测量的平均缺损程度、可逆性量、增厚分数和射血分数无显著变化。
Background Enhanced external counterpulsation (EECP) reduces angina and extends time to exercise-induced ischemia in patients with symptomatic coronary disease. One- and two-center studies and a retrospective case series reported that EECP improves myocardial perfusion in stable angina pectoris. We sought to critically evaluate and quantify the effect of EECP on myocardial perfusion.Methods In 6 US university hospitals, EECP was performed for 35 hours in patients with class II to IV angina who had exercise-induced myocardial ischemia. Symptom-limited quantitative gated technetium Tc 99m sestamibi single photon emission computed tomography exercise perfusion imaging was performed at baseline and 1 month post-EECP. Sestamibi was injected at the some heart rate in both stress tests. Single photon emission computed tomography images were read at a blinded core laboratory.Results Thirty-seven patients were enrolled, 34 of whom completed pre- and post-EECP stress testing. The mean age was 61 +/- 10 years, 81% were male, 78% had prior revascularization, and 68% had 3-vessel disease. The mean angina class decreased from 2.7 +/- 0.7 at baseline to 1.7 +/- 0.7 after EECP (P < .001). Exercise duration increased from 9.1 +/- 3.7 minutes at baseline to 10.2 +/- 3.6 minutes post-EECP (P = .03). The average percentage of tracer uptake, magnitude of reversibility, average thickening fraction, and the left ventricular ejection fraction remained unchanged after EECP.Conclusions We confirm previous report that EECP reduces angina and improves exercise capacity. There were no significant changes in mean defect magnitude, amount of reversibility, thickening fraction, and ejection fraction measured using myocardial quantitative single photon emission computed tomography imaging when compared at identical pre- and post-EECP heart rates.