title: Angina patients with diastolic versus systolic heart failure demonstrate comparable immediate and one-year benefit from enhanced external counterpulsation.
abstract: BACKGROUND
  Enhanced external counterpulsation (EECP) is effective in treating angina in coronary artery disease patients. Whether EECP produces similar immediate and sustained benefits and freedom from adverse events (MACE) at 1 year in patients with severe systolic dysfunction versus diastolic dysfunction is unknown.
  
  
  RESULTS
  Data of 746 angina patients with a history of heart failure enrolled in the International EECP Registry were divided into 2 groups: left ventricular ejection fraction (LVEF) < or =35% (S) and LVEF >35% (D). Mean LVEF was 51.0 +/- 10.2% in diastolic dysfunction (n=391) versus 26.3 +/- 6.9% in systolic dysfunction (n=355). At baseline, 92.0% of diastolic dysfunction and 90.9% of systolic had Canadian Cardiovascular Society Class III/IV angina with similar number of anginal episodes and nitroglycerin use. After 32 hours of EECP, angina was reduced by > or =1 class in 71.9% of diastolic versus 72.2% of systolic with similar decreases in anginal episodes and nitroglycerin use. At 1-year 78.1% of diastolic and 75.8% of systolic have less angina than pre-EECP. MACE at 1 year was also comparable (24.4 versus 23.8%).
  
  
  CONCLUSIONS
  The benefits of EECP in heart failure patients were similar regardless of diastolic or systolic dysfunction. The improvement was sustained at 1 year with similar MACE.
authors.affiliation: SUNY Stony Brook, Stony Brook, NY 11740, USA.
authors.forename: William E
authors.initials: WE
authors.lastname: Lawson
authors.forename: Marc A
authors.initials: MA
authors.lastname: Silver
authors.forename: John C K
authors.initials: JC
authors.lastname: Hui
authors.forename: Elizabeth D
authors.initials: ED
authors.lastname: Kennard
authors.forename: Sheryl F
authors.initials: SF
authors.lastname: Kelsey
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy*; D015897:Comorbidity; D015908:Counterpulsation / Q000379:methods; D005260:Female; D006333:Heart Failure / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D013318:Stroke Volume; D016896:Treatment Outcome