{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,11,22]],"date-time":"2023-11-22T13:44:18Z","timestamp":1700660658971},"reference-count":40,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2012,10,25]],"date-time":"2012-10-25T00:00:00Z","timestamp":1351123200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2013,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background:<\/jats:title><jats:p>Comorbid aortic stenosis (AS) has been considered a precaution when applying enhanced external counterpulsation (EECP) to individuals with angina due to concerns about treatment\u2010related hemodynamic changes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis:<\/jats:title><jats:p>The aim of this study was to determine whether EECP safely reduces symptoms of myocardial ischemia and improves hemodynamics in individuals with AS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p>Forty\u2010three 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>Thirty\u2010five 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 (<jats:italic>P &lt;<\/jats:italic> 0.0001). There was no statistical difference between the percentages in patients with and without AS (<jats:italic>P<\/jats:italic> = 0.54). CCS angina class outcome was not associated with AS severity (<jats:italic>P<\/jats:italic> = 0.55). The percentage of patients with diastolic augmentation ratio \u22651.0 was 16.3% in both groups at baseline and improved to 39.5% in AS patients and 37.2% in non\u2010AS patients after EECP (both <jats:italic>P<\/jats:italic> = 0.002). The average decreases in systolic blood pressure in subjects with AS (\u221215 mm Hg, 95% CI: 11 to 20, <jats:italic>P &lt;<\/jats:italic> 0.0001) and without AS (\u221218 mm Hg, 95% CI: 14 to 22, <jats:italic>P &lt;<\/jats:italic> 0.0001) were similar (<jats:italic>P<\/jats:italic> = 0.31). No major adverse cardiac events were reported.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p>Angina patients with AS who undergo EECP had clinically important symptomatic and hemodynamic improvements comparable to their non\u2010AS counterparts. <jats:italic>Clin. Cardiol.<\/jats:italic> 2012 doi: 10.1002\/clc.22073<\/jats:p><jats:p>The authors have no funding, financial relationships, or conflicts of interest to disclose.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.22073","type":"journal-article","created":{"date-parts":[[2012,10,25]],"date-time":"2012-10-25T14:21:54Z","timestamp":1351174914000},"page":"82-87","source":"Crossref","is-referenced-by-count":5,"title":["The Safety and Efficacy of Enhanced External Counterpulsation as a Treatment for Angina in Patients With Aortic Stenosis"],"prefix":"10.1002","volume":"36","author":[{"given":"Debra L.","family":"Braverman","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Len","family":"Braitman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincent M.","family":"Figeuredo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,10,25]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e3182009701"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39465.522569.80"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(99)00140-0"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1053\/euhj.2000.2545"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(02)02191-4"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2261-6-28"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.2310\/6650.2002.33514"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2003.10.044"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/clc.4960230406"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/clc.20117"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2005.07.122"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2008.12.002"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.104.486738"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(93)90249-Z"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(96)00563-3"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/MOL.0b013e3282a66099"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.923482"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/000331970105201001"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/clc.4960240604"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.2459\/01.JCM.0000223255.24309.fa"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.2005.01604.x"},{"key":"e_1_2_6_23_2","first-page":"e1","article-title":"focused update incorporated into the ACC\/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the 1998 guidelines for the management of patients with valvular heart disease). 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