Abstract 2414: Enhanced External Counterpulsation Therapy Improves Angina and Functional Status in Patients with Severe Left Ventricular Systolic Dysfunction
Enhanced external counterpulsation (EECP) therapy, a non-invasive assisted circulation device, can be safely performed in patients with severe symptomatic left ventricular systolic dysfunction (LVSD). Little information is available about the efficacy of this therapy in such patients. We analyzed the data on 2454 patients (mean age 67 ± 11 years, 74% men) enrolled in the phase 2 International EECP Patient Registry (IEPR-2) in order to evaluate the efficacy of EECP therapy in severe LVSD. Patients were divided into 4 groups based on baseline LVEF: > 50% (n = 1047), 35–50% (n = 826), 20–34% (n = 424), and < 20% (n = 157). Patients underwent a standard course of 35 one-hour EECP treatment sessions. One-year follow up data was compared between the 4 groups (Table⇓). Patients with severe LVSD (LVEF < 35%) were older, had higher prevalence of prior myocardial infarction, CABG , congestive heart failure, peripheral vascular disease, stroke, diabetes, renal failure and atrial arrhythmias as well as pacemaker or defibrillator implantation[all p < 0.01]. However, response to EECP therapy at 1-year follow-up was similar in all groups when assessed by the % improvement in angina frequency ( Δ Angina), % reduction in nitroglycerin usage (Δ NTG), % improvement in Duke Activity Score Index (Δ DASI), or MACE free survival rates (MACE = major adverse cardiac events = death, myocardial infarction or revascularization) (all p = NS). EECP therapy is effective at 1-year follow up across the range of LVEF from < 20% to > 50% irrespective of co-morbid conditions.