Enhanched External Counterpulsation Therapy Improves Clinical Outcomes, Quality of Life and Functional Effort Capacity in Patients with Symptomatic Heart Failure

Yıl 2020, Cilt: 1 Sayı: 3, 104 - 108, 25.12.2020

Meltem Refiker Ege Özlem Soran

https://doi.org/10.51261/yiu.2020.00024

Öz

Introduction: Symptomatic chronic heart failure is an important health problem that limits the daily life, quality of life, effort capacity and physiological condition of the patients. In subset of these patients symptoms persist despite optimal medical management. Enhanced External Counterpulsation EECP is a non-invasive Food and Drug Administration FDA approved therapy which improves symptoms and clinical outcomes in patients with heart failure. However, there is limited data in Turkish cohort. In this study, we investigated the clinical effects of EECP on multiple parameters in Turkish patients with symptomatic chronic heart failure. Material and Methods: Twenty-one individuals who were diagnosed with symptomatic chronic heart failure left ventricular ejection fraction ≤40% with New York Heart Association Class NYHA II-III were enrolled in the study. Patients were assigned to 35-session EECP treatment. NYHA classification, SF-36 quality of life questionnaire, Minnesota living heart failure questionnaire, quality of life index cardiac version-IV and Beck depression scale were assessed, and 6-minute walk tests were performed before and after EECP treatment. Results: The mean age of the patients was 57.4±12.5 years. EECP therapy resulted in significant improvement in NYHA functional class, quality of life index, effort capacity and pyhsiological condition in all patients without any adverse event p=0.001 . Conclusion: Enchanced external counterpulsation treatment significantly improved clinical parameters and effort capacity in patients with symptomatic heart failure. These results suggest that EECP is an effective and a safe therapy in Class II-III heart failure patients whose symptoms persist despite optimal medical management

Anahtar Kelimeler

heart failure, symptom, quality of life, depression, EECP

Güçlendirilmiş Eksternal Kontrpulsasyon Tedavisi Semptomatik Kalp Yetmezliği Hastalarında Klinik Sonuçları, Hayat Kalitesini ve Fonksiyonel Efor Kapasitesini İyileştirir

Öz

Giriş: Semptomatik kronik kalp yetmezliği hastaların günlük hayatını, hayat kalitesini, efor kapasitesini ve psikolojik durumunu olumsuz yönde etkileyen önemli bir sağlık problemidir. Optimal medikal tedaviye rağmen bir grup hastada şikâyetler devam eder. Güçlendirilmiş Eksternal Kontrpulsasyon EECP tedavisi kalp yetmezliği hastalarında semptomları ve klinik sonuçları iyileştiren, FDA Food and Drug Administration onaylı, girişim gerektirmeyen bir tedavi yöntemidir. Buna rağmen Türk hastalarda kısıtlı bilgi mevcuttur. Bu çalışmada, semptomatik kronik kalp yetmezliği olan Türk hastalarda EECP’nin birçok parametreye etkisi araştırılmıştır. Materyal ve Metodlar: New York kalp yetmezliği sınıf NYHA IIIII olan semptomatik kronik kalp yetmezliği sol ventrikül ejeksiyon fraksiyonu ≤%40 tanısı almış 21 hasta çalışmaya dâhil edilmiştir. Hastalar 35 seans EECP tedavisine alınmıştır. Hastalara NYHA sınıflaması, “SF36 quality of life” yaşam kalitesi ölçeği anketi, “Minnesota living heart failure” Minnesota kalp yetmezliği ile yaşam anketi, “quality of life indeks cardiac version-IV” yaşam kalitesi indeksi, kardiyak versiyonu skorlaması ve “Beck” depresyon skalası uygulanarak, tedavi öncesi ve sonrası 6 dakika yürüme testleri yapılmıştır. Bulgular: Hastaların ortalama yaşı 57,4±12,5 yıl idi. Tüm hastalarda EECP tedavisi hiçbir advers olay görülmeden NYHA fonksiyonel sınıflaması, hayat kalitesi indeksi, efor kapasitesi ve psikolojik durumda belirgin iyileşmeye neden olmuştur p=0,001 . Sonuç: Semptomatik kalp yetmezliği hastalarında EECP tedavisi klinik parametreleri ve efor kapasitesini iyileştirir. Bu sonuçlar göstermiştir ki EECP tedavisi optimal medikal tedaviye rağmen semptomları devam eden NYHA sınıf II-III hastalarda etkili ve güvenli bir tedavi yöntemidir.

Anahtar Kelimeler

kalp yetmezliği, semptom, hayat kalitesi, depresyon, EECP

Kaynakça

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