PMID- 16979005
OWN - NLM
STAT- MEDLINE
DCOM- 20061017
LR  - 20220311
IS  - 1558-3597 (Electronic)
IS  - 0735-1097 (Linking)
VI  - 48
IP  - 6
DP  - 2006 Sep 19
TI  - Enhanced external counterpulsation improves exercise tolerance in patients with 
      chronic heart failure.
PG  - 1198-205
AB  - 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.
FAU - Feldman, Arthur M
AU  - Feldman AM
AD  - Department of Medicine, Jefferson Medical College, Philadelphia, Pennsylvania, 
      USA. Arthur.Feldman@jefferson.edu
FAU - Silver, Marc A
AU  - Silver MA
FAU - Francis, Gary S
AU  - Francis GS
FAU - Abbottsmith, Charles W
AU  - Abbottsmith CW
FAU - Fleishman, Bruce L
AU  - Fleishman BL
FAU - Soran, Ozlem
AU  - Soran O
FAU - de Lame, Paul-Andre
AU  - de Lame PA
FAU - Varricchione, Thomas
AU  - Varricchione T
CN  - PEECH Investigators
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20060828
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
SB  - IM
CIN - J Am Coll Cardiol. 2006 Sep 19;48(6):1206-7. PMID: 16979006
MH  - Aged
MH  - Chronic Disease
MH  - Counterpulsation/*methods
MH  - *Exercise Tolerance
MH  - Female
MH  - Heart Failure/drug therapy/*physiopathology/*therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Severity of Illness Index
EDAT- 2006/09/19 09:00
MHDA- 2006/10/18 09:00
CRDT- 2006/09/19 09:00
PHST- 2005/06/22 00:00 [received]
PHST- 2005/08/31 00:00 [revised]
PHST- 2005/10/19 00:00 [accepted]
PHST- 2006/09/19 09:00 [pubmed]
PHST- 2006/10/18 09:00 [medline]
PHST- 2006/09/19 09:00 [entrez]
AID - S0735-1097(06)01129-6 [pii]
AID - 10.1016/j.jacc.2005.10.079 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2006 Sep 19;48(6):1198-205. doi: 10.1016/j.jacc.2005.10.079. 
      Epub 2006 Aug 28.