Background. Postacute sequelae of SARS-CoV-2 infection (PASC) are a novel clinical syndrome characterized in part by endothelial dysfunction. Enhanced external counterpulsation (EECP) produces pulsatile shear stress, which has been associated with improvements in systemic endothelial function. Objective. To explore the effects of EECP on symptom burden, physical capacity, mental health, and health-related quality of life (HRQoL) in patients with PASC-associated angina and microvascular dysfunction (MVD). Methods. An interventional pilot study was performed, including 10 patients (male = 5, mean age 50.3 years) recruited from a tertiary specialized PASC clinic. Patients with angina and MVD, defined as index of microcirculatory resistance (IMR) ≥25 and/or diagnosed through stress perfusion cardiac magnetic resonance imaging, were included. Patients underwent one modified EECP course (15 one-hour sessions over five weeks). Symptom burden, six-minute walk test, and validated generic self-reported instruments for measuring psychological distress and HRQoL were assessed before and one month after treatment. Results. At baseline, most commonly reported PASC symptoms were angina (100%), fatigue (80%), and dyspnea (80%). Other symptoms included palpitations (50%), concentration impairment (50%), muscle pain (30%), and brain fog (30%). Mean IMR was 63.6. After EECP, 6MWD increased (mean 29.5 m, median 21 m) and angina and fatigue improved. Mean depression scores showed reduced symptoms (−0.8). Mean HRQoL scores improved in seven out of eight subscales (+0.2 to 10.5). Conclusions. Patients with PASC-associated angina and evidence of MVD experienced subjective and objective benefits from EECP. The treatment was well-tolerated. These findings warrant controlled studies in a larger cohort.

中文翻译：

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增强体外反搏治疗 SARS-CoV-2 相关微血管心绞痛和疲劳的急性后遗症：一项介入性试点研究

背景。SARS-CoV-2 感染的急性后遗症 (PASC) 是一种新型临床综合征，部分特征为内皮功能障碍。增强型体外反搏（EECP）产生脉动剪切应力，这与全身内皮功能的改善有关。客观的。探讨 EECP 对 PASC 相关心绞痛和微血管功能障碍 (MVD) 患者的症状负担、身体能力、心理健康和健康相关生活质量 (HRQoL) 的影响。方法。进行了一项介入性试点研究，包括从三级专业 PASC 诊所招募的 10 名患者（男性 = 5，平均年龄 50.3 岁）。患有心绞痛和 MVD 的患者（定义为微循环阻力指数 (IMR) ≥25 和/或通过负荷灌注心脏磁共振成像诊断）被纳入。患者接受了一次改良的 EECP 课程（五周内 15 次一小时的疗程）。在治疗前和治疗后一个月对症状负担、六分钟步行测试以及用于测量心理困扰和 HRQoL 的经过验证的通用自我报告仪器进行了评估。结果。基线时，最常见的 PASC 症状是心绞痛 (100%)、疲劳 (80%) 和呼吸困难 (80%)。其他症状包括心悸（50%）、注意力不集中（50%）、肌肉疼痛（30%）和脑雾（30%）。平均 IMR 为 63.6。EECP 后，6MWD 增加（平均 29.5 m，中位 21 m），心绞痛和疲劳得到改善。平均抑郁评分显示症状减轻（-0.8）。八个子量表中的七个的平均 HRQoL 分数有所提高（+0.2 至 10.5）。结论。患有 PASC 相关心绞痛和 MVD 证据的患者从 EECP 中获得了主观和客观的益处。治疗耐受性良好。这些发现值得在更大的队列中进行对照研究。