Abstract 4144084: Enhanced External Counterpulsation as a Novel Treatment for Heart Transplant Candidates with Ischemic Heart Failure with Reduced Ejection Fraction
Bibliographic record
Abstract
Introduction: Enhanced External Counterpulsation (EECP) is a noninvasive outpatient therapy designed to improve arterial health, cardiac efficiency, and coronary collateral formation by applying sequential external pressure aligned with the patient’s cardiac cycle. It is primarily indicated for refractory angina that is not amenable to PCI or CABG with the opinion of a cardiologist. EECP can improve exercise tolerance, reduce anginal symptoms, and enhance endothelial function, offering a potential alternative for patients with ischemic HFrEF awaiting heart transplantation. Description of a Case: A 58-year-old Hispanic female with a history of severe CAD, type II DM, hyperlipidemia, and CVA. A transthoracic echocardiogram (TTE) revealed a dilated LV with an EF of 20%, left atrial enlargement, severe mitral regurgitation, moderate tricuspid regurgitation, right ventricular systolic pressure of 42 mm HG, trivial pericardial effusion, akinesis of the inferior wall, and hypokinesis of the anterior wall. Despite being a heart transplantation candidate, she declined revascularization and sought alternative treatments for angina, dyspnea, and daily activity limitations. The patient underwent EECP, consisting of 35 one-hour sessions over seven weeks. Following EECP, the patient demonstrated improvements in her Canadian Cardiovascular Society angina score (IV to I), New York Association class (IV to I), six-minute walk test performance, and EF (increased to 55%, observed from TTE). Due to these improvements, she was delisted for heart transplantation. Discussion: This case illustrates the potential of EECP as an effective noninvasive treatment for patients with symptomatic ischemic HFrEF who are awaiting heart transplantation but are ineligible or unwilling to undergo surgical interventions. Not only did EECP improve the patient's angina and functional status, but it also enhanced her cardiac function. Based on the findings of this case report, further studies should be done to expand the indications of EECP to include HF and other similar patient populations. EECP may alleviate the need for heart transplantation through its integration as a standard early intervention.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".