OBJECTIVES: The PEECH (Prospective Evaluation of Enhanced External Counterpulsation in Congestive Heart Failure) study assessed the benefits of enhanced external counterpulsation (EECP) in the treatment of patients with mild-to-moderate heart failure (HF). BACKGROUND: Enhanced external counterpulsation reduced angina symptoms and extended time to exercise-induced ischemia in patients with coronary artery disease, angina, and normal left ventricular function. A small pilot study and registry analysis suggested benefits in patients with HF. METHODS: We randomized 187 subjects with mild-to-moderate symptoms of HF to either EECP and protocol-defined pharmacologic therapy (PT) or PT alone. Two co-primary end points were pre-defined: the percentage of subjects with a 60 s or more increase in exercise duration and the percentage of subjects with at least 1.25 ml/min/kg increase in peak volume of oxygen uptake (VO2) at 6 months. RESULTS: By the primary intent-to-treat analysis, 35% of subjects in the EECP group and 25% of control subjects increased exercise time by at least 60 s (p = 0.016) at 6 months. However, there was no between-group difference in peak VO2 changes. New York Heart Association (NYHA) functional class improved in the active treatment group at 1 week (p < 0.01), 3months (p < 0.02), and 6 months (p < 0.01). The Minnesota Living with Heart Failure score improved significantly 1 week (p < 0.02) and 3 months after treatment (p = 0.01). CONCLUSIONS: In this randomized, single-blinded study, EECP improved exercise tolerance, quality of life, and NYHA functional classification without an accompanying increase in peak VO2.
RCT Entities:
OBJECTIVES: The PEECH (Prospective Evaluation of Enhanced External Counterpulsation in Congestive Heart Failure) study assessed the benefits of enhanced external counterpulsation (EECP) in the treatment of patients with mild-to-moderate heart failure (HF). BACKGROUND: Enhanced external counterpulsation reduced angina symptoms and extended time to exercise-induced ischemia in patients with coronary artery disease, angina, and normal left ventricular function. A small pilot study and registry analysis suggested benefits in patients with HF. METHODS: We randomized 187 subjects with mild-to-moderate symptoms of HF to either EECP and protocol-defined pharmacologic therapy (PT) or PT alone. Two co-primary end points were pre-defined: the percentage of subjects with a 60 s or more increase in exercise duration and the percentage of subjects with at least 1.25 ml/min/kg increase in peak volume of oxygen uptake (VO2) at 6 months. RESULTS: By the primary intent-to-treat analysis, 35% of subjects in the EECP group and 25% of control subjects increased exercise time by at least 60 s (p = 0.016) at 6 months. However, there was no between-group difference in peak VO2 changes. New York Heart Association (NYHA) functional class improved in the active treatment group at 1 week (p < 0.01), 3months (p < 0.02), and 6 months (p < 0.01). The Minnesota Living with Heart Failure score improved significantly 1 week (p < 0.02) and 3 months after treatment (p = 0.01). CONCLUSIONS: In this randomized, single-blinded study, EECP improved exercise tolerance, quality of life, and NYHA functional classification without an accompanying increase in peak VO2.
Authors: Darren T Beck; Jeffrey S Martin; Darren P Casey; Joseph C Avery; Paloma D Sardina; Randy W Braith Journal: Clin Exp Pharmacol Physiol Date: 2014-09 Impact factor: 2.557
Authors: J Malcom O Arnold; Jonathan G Howlett; Paul Dorian; Anique Ducharme; Nadia Giannetti; Haissam Haddad; George A Heckman; Andrew Ignaszewski; Debra Isaac; Philip Jong; Peter Liu; Elizabeth Mann; Robert S McKelvie; Gordon W Moe; John D Parker; Anna M Svendsen; Ross T Tsuyuki; Kelly O'Halloran; Heather J Ross; Vivek Rao; Errol J Sequeira; Michel White Journal: Can J Cardiol Date: 2007-01 Impact factor: 5.223
Authors: Margaret M Redfield; Horng H Chen; Barry A Borlaug; Marc J Semigran; Kerry L Lee; Gregory Lewis; Martin M LeWinter; Jean L Rouleau; David A Bull; Douglas L Mann; Anita Deswal; Lynne W Stevenson; Michael M Givertz; Elizabeth O Ofili; Christopher M O'Connor; G Michael Felker; Steven R Goldsmith; Bradley A Bart; Steven E McNulty; Jenny C Ibarra; Grace Lin; Jae K Oh; Manesh R Patel; Raymond J Kim; Russell P Tracy; Eric J Velazquez; Kevin J Anstrom; Adrian F Hernandez; Alice M Mascette; Eugene Braunwald Journal: JAMA Date: 2013-03-27 Impact factor: 56.272