Document Detail


Sequential external counterpulsation: an adjunctive therapy for patients with chronic coronary artery disease and left ventricular dysfunction.
MedLine Citation:
PMID:  8682555     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We assessed the clinical and haemodynamic improvement with 3 weeks of sequential external counterpulsation (SECP) therapy in 23 patients with chronic coronary artery disease (CAD) and left ventricular (LV) dysfunction who were refractory to maximal tolerated doses of medical therapy and in whom intervention or surgery was not contemplated. All patients were subjected to one-hour duration of SECP for 3 weeks. SECP is a new noninvasive tool which increases coronary artery filling utilizing external pressure in a sequential manner from calf to thigh. A detailed clinical and echocardiographic evaluation was done before and after the completion of therapy to assess the utility of SECP. There were 18 males and 5 females with a mean age of 53 years. On coronary angiography, 39 percent patients had single, 8.7 percent had double and 48 percent had triple vessel disease. Four patients had coronary artery bypass graft (CABG) surgery in the past. Out of all patients, 48 percent had diffuse or distal coronary artery disease which was considered not suitable for CABG, 22 percent were not willing for intervention and 30 percent had other systemic diseases making them unfit for surgery. After 3 weeks of SECP, the anginal frequency reduced from 9 episodes/week to 1 episode/week. Before SECP, 74 percent patients were in NYHA class III, whereas only 8.7 percent were class III symptomatic after SECP. All patients claimed symptomatic improvement of a mean of 6.8 +/- 1.4 on a visual analog scale of 1-10. After SECP, the LV diastolic dimensions reduced from 54.6 +/- 7 to 51 +/- 7 mm, systolic dimensions reduced from 40 +/- 8 to 36 +/- 8 mm and LVEF increased from 32.7 +/- 9 to 37.4 +/- 8.5 percent. In conclusion, 3 weeks of therapy with SECP produces significant improvement in symptomatic status and cardiac function in patients with chronic CAD and LV dysfunction, refractory to medical therapy.
Authors:
R R Kasliwal; S Mittal; A Kanojia; M L Bhatia; I Kronzon; N Trehan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Indian heart journal     Volume:  48     ISSN:  0019-4832     ISO Abbreviation:  Indian Heart J     Publication Date:    1996 Mar-Apr
Date Detail:
Created Date:  1996-08-20     Completed Date:  1996-08-20     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0374675     Medline TA:  Indian Heart J     Country:  INDIA    
Other Details:
Languages:  eng     Pagination:  150-4     Citation Subset:  IM    
Affiliation:
Escorts Heart Institute, Okhla Road, New Delhi.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Chronic Disease
Coronary Disease / physiopathology,  therapy*,  ultrasonography
Counterpulsation*
Echocardiography
Female
Hemodynamics
Humans
Male
Middle Aged
Treatment Outcome
Ventricular Dysfunction, Left / physiopathology,  therapy*,  ultrasonography

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