The effectiveness of the method of external counterpulsation in patients with chronic stable angina

Abstract

Purpose: to evaluate the effectiveness of multipurpose treatment of patients with chronic stable angina pectoris using the method of external counterpulsation (ECP). Materials and methods: a total of 92 patients with chronic stable angina included in the comparative analysis, which divided into 2 groups: the main group and the control group. The main group consisted of 57 patients who received one course of treatment using the ECP method, the control group consisted of 35 patients. Before and after the treatment, all patients underwent the following: general clinical examination, including the determination of the functional class of angina pectoris and the need to use nitroglycerin preparations; echocardiographic examination; stress-ECG test; quality of life assessment (based on the Seattle Quality of Life Questionnaire (Seattle Angina Questionnaire)). Results: a decrease in the average functional class of angina pectoris noted more in the ECP group than in the control group (from 2.280.73 to 0.930.80, p0.05 vs. from 2.340.73 to 1.830.71, p0.05). A decrease in the functional class of angina at least in one functional class was significantly higher in the main group (78.9% vs. 57.1%, p=0.0258). The use of nitroglycerin sharply decreased after treatment in the ECP group (by 51.6%, p=0.002), and in the control group, despite a slight decrease (by 22.7%), the changes did not reach the level of statistical significance (p=0.0736). When comparing the dynamics of changes in echocardiographic parameters, the dynamics turned out to be approximately the same in both groups. Differences obtained only for the dynamics of the left ventricular ejection fraction, which was greater in the ECP group (an increase of 4.695.56% vs. an increase of 1.755.15%, p=0.0448). The dynamics of all indicators of the stress-ECG test is significantly different in the main and control groups, and the dynamics in the ECP group are positive, but in the control group are negative. When comparing the data of quality of life, the dynamics of changes on some scales are insignificant and the same for both groups, for example, on the physical limitation scale, but on some scales (scales of angina stability and angina frequency), the dynamics of improvement in the ECP group are much higher than in the control group (30-37 points vs. 12-13 points respectively, p0.0001). The overall quality of life assessment score improved significantly more in the ECP group than in the control group (+96.1040.73 vs. +45.3135.06, p0.0001). Conclusion: the study showed that the method of external counterpulsation can be used in clinical practice as part of the multipurpose treatment of patients with chronic stable angina. The use of this technique has significantly reduced the class of angina, reduced the need for using nitroglycerin preparations, and improved some number of echocardiographic, stress-ECG test and quality of life indicators.