Treating heart failure with enhanced external counterpulsation (EECP): design of the Prospective Evaluation of EECP in Heart Failure (PEECH) trial.
BACKGROUND
Enhanced external counterpulsation (EECP) treatment can improve exercise tolerance in patients with ischemic heart disease; however, the possible benefits of EECP in patients with stable heart failure (HF) and left ventricular dysfunction (LVD) are unclear. An open pilot study showed significant increases in exercise tolerance in HF patients undergoing EECP. Thus a larger, controlled study of EECP in patients with stable HF (New York Heart Association [NYHA] classes II and III) and LVD was undertaken.


RESULTS
The PEECH trial is a controlled, randomized, single-blind, parallel-group, multicenter study of 187 patients with symptomatic but stable HF (NYHA classes II and III) and an LV ejection fraction < or =35% was designed to assess the efficiency of EECP in patients with stable HF. Medical therapy is optimized in all patients based on the recommendations of the Heart Failure Society of America ("Usual Care"), and then randomized between 2 treatment groups; UC or EECP (35 hours over 7 weeks).


CONCLUSIONS
Efficacy measures include standard exercise tolerance tests on a treadmill (modified Naughton protocol), with measurements of peak oxygen uptake and exercise duration time; quality of life questionnaires; NYHA classification; and neurohormonal markers of HF.
Feldman
Arthur M
AM
Department of Medicine, Jefferson Medical College, 1025 Walnut Street, Philadelphia, PA 19607, USA.
Silver
Marc A
MA
Francis
Gary S
GS
De Lame
Paul-André
PA
Parmley
William W
WW
D015908:Counterpulsation / Q000379:methods*; D005080:Exercise Test; D017079:Exercise Tolerance / Q000502:physiology; D006333:Heart Failure / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D010101:Oxygen Consumption / Q000502:physiology; D018579:Patient Selection; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D016037:Single-Blind Method; D011795:Surveys and Questionnaires