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主動脈瓣狹窄的心絞痛患者接受體外反搏後,症狀和血流動力學均得到了重要的臨床改善

Angina Patients with Aortic Stenosis who undergo EECP had Clinically Important Symptomatic and Hemodynamic Improvements

Source From 資料來源 : https://pubmed.ncbi.nlm.nih.gov/23109041/

 

Angina Patients with Aortic Stenosis who undergo EECP had Clinically Important Symptomatic and Hemodynamic Improvements

BACKGROUND:

Comorbid aortic stenosis (AS) has been considered a precaution when applying enhanced external counterpulsation (EECP) to individuals with angina due to concerns about treatment-related hemodynamic changes.

HYPOTHESIS:

The aim of this study was to determine whether EECP safely reduces symptoms of myocardial ischemia and improves hemodynamics in individuals with AS.

METHODS:

Forty-three patients with AS (average age, 73 years; 86% male) and 43 comparison patients without AS were chosen from a database of 1327 EECP patients. Canadian Cardiovascular Society (CCS) Functional Angina Classification, diastolic augmentation ratio, and blood pressure were measured at baseline and on completion of the course of EECP.

RESULTS:

Thirty-five of the 43 patients with AS (81%, 95% CI: 66.6% to 91.6%) and 38 of the 43 without AS (88%, 95% CI: 74.9% to 96.1%) improved in angina class (P < 0.0001). There was no statistical difference between the percentages in patients with and without AS (P = 0.54). CCS angina class outcome was not associated with AS severity (P = 0.55). The percentage of patients with diastolic augmentation ratio ≥1.0 was 16.3% in both groups at baseline and improved to 39.5% in AS patients and 37.2% in non-AS patients after EECP (both P = 0.002). The average decreases in systolic blood pressure in subjects with AS (-15 mm Hg, 95% CI: 11 to 20, P < 0.0001) and without AS (-18 mm Hg, 95% CI: 14 to 22, P < 0.0001) were similar (P = 0.31). No major adverse cardiac events were reported.

CONCLUSIONS:

Angina patients with AS who undergo EECP had clinically important symptomatic and hemodynamic improvements comparable to their non-AS counterparts.

 

「增強型體外反搏治療主動脈瓣狹窄患者心絞痛的安全性和有效性」

背景

由於擔心與治療相關的 血流動力學 變化,在對心絞痛患者進行體外反搏(EECP)治療時,合併主動脈瓣狹窄(AS)一直被認為是一種預防措施。

假設

本研究旨在確定 EECP 是否能安全減輕 AS 患者的心肌缺血症狀並改善血液動力學。

方法

從 1327 名 EECP 患者的資料庫中挑選了 43 名 AS 患者(平均年齡 73 歲,86% 為男性)和 43 名無 AS 的對比患者。在基線和 EECP 療程結束時測量了加拿大心血管協會(CCS)功能性心絞痛分級、舒張增強比和血壓。

結果

43名患有AS的患者中,有35名(81%,95% CI:66.6% 至91.6%)和43名無AS患者中的38名(88%,95% CI:74.9% 至96.1%)心絞痛等級得到改善(P < 0.0001)。 患有和不患有AS的患者的百分比沒有統計學差異(P = 0.54)。 CCS 心絞痛等級結果與 AS 嚴重程度無關 (P = 0.55)。 兩組基線時舒張壓增強比≥1.0的患者百分比均為16.3%,EECP後AS患者和非AS患者的這一比例分別提高至39.5%和37.2%(均P = 0.002)。 患有AS 的受試者(-15 mm Hg,95% CI:11 至20,P < 0.0001)和不患有AS 的受試者(-18 mm Hg,95% CI:14 至22,P < 0.0001)收縮壓平均下降相似(P = 0.31)。 沒有報告重大不良心臟事件。

結論

接受 EECP 的 AS 心絞痛患者與非 AS 患者相比,具有臨床重要的症狀和 血流動力學 改善。

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