Left Ventricular Revers Re-Modeling Induced by Muscular Counterpulsation (Preliminary Report)

Search for the successful and simple method of the CHF radical correction still remains a greatest problem in Cardiology. Notable improvement of contractility together with significant diminishing of abnormal, enlarged LV could be an independent proof for the result oriented treatment approach.

Objective: Investigate the level of LV revers re-modeling induced by long-term muscular counterpulsation (MCP) application in CHF patients.

Materials and methods. Prospective study was performed on 21 DCMP (ischemic and idiopathic) patients with severe CHF (average NYHA 3.7±05) in stable phase.

Study protocol started with Control Period (5 month maximal pharm treatment according guideline) and then continued with MCP Period (3 times 10 procedures with 2 month brakes in between). The procedures were performed by using apparatus “CardioLa” (Winterthur, CH). Echocardiography and noninvasive hemodynamics were measured at base line, before and after MCP procedures.

Results. Patients finished the study with notable improvement of hemodynamic parameters and health status. EchoCG evidences are presented in the table below:

According to our findings 5 month maximal pharm-therapy gave no result in severe CHF patients, but combined drug-device approach with 30 MCP fractional procedures was successful enough for diminishing LV chamber volume (EDV=212.3±62.0), augmenting myocardial contractility (EF=42.0±6.4%) and reducing NYHA class till 1.7±0.6.

Conclusion. Long-term MCP can achieve deepest possible level of LV revers re-modeling. MCP can be considered as a simple but most effective destination treatment way in CHF patients.