MDNews - San Antonio

February 2018

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1 0 L E G A C Y H E A R T C A R E : SPECIAL CLINICAL SECTION: CARDIOLOGY How EECP and Chronic Disease Management Are Taking Patient-centered Care to a New Level DESPITE STE ADY ADVANCEMENTS IN MEDICAL CARE, THE EPIDEMIC OF CHRONIC DISE A SE CONTINUES TO AFFECT MORE THAN HALF OF ALL AMERICANS E ACH YE AR, DEPRIVING MILLIONS OF THE QUALIT Y OF LIFE THE Y DESERVE WHILE ACCOUNTING FOR 86 PERCENT OF THE NATION'S $2.7 TRILLION ANNUAL HE ALTHCARE E XPENDITURES 1 . CARDIOVA SCUL AR DISE A SE, IN PARTICUL AR, REMAINS THE NO.1 CAUSE OF MORBIDIT Y AND MORTALIT Y PL AGUING ADULTS, RESPONSIBLE FOR 1 IN E VERY 4 DE ATHS 2 . LEGACY HE ART CARE œ WITH ITS COMMITMENT TO QUALIT Y CARE, PATIENT EDUCATION AND CLINICAL RESE ARCH œ IS EMERGING ON THE FRONTLINES A S A KE Y PL AYER IN PATIENT£CENTERED CARE. A S THE L ARGEST PROVIDER OF ENHANCED E X TERNAL COUNTERPULSATION ¤EECP¥ SINCE 2003, LEGACY'S MISSION IS SIMPLE: TO IMPROVE THE HE ALTH AND TOUCH THE LIFE OF E VERY PATIENT IT TRE ATS. BY PHOEBE CHI, MD, MPH, DIRECTOR OF CLINICAL EDUCATION, LEGACY HEART CARE EECP I S A noninvasive cardio- vascular treatment for chronic angina that uses pneumatic cu˜s to sequentially compress the lower extremities along with the cardiac cycle in a way that leads to diastolic au g ment at ion a nd de crea sed a f terload. Treatment response rates a mong patients a re high; more than 85 percent of patients undergoing EECP report noticeable improvement in symptoms within a few weeks of initiation, with studies demonstrating decreased frequency of anginal episodes, decreased need for nitrates, improved exercise tolerance and increase in the time to exercise-induced ischemia 3 . While research continues to strengthen the understanding of the physiologic mechanisms behind the therapeutic e˜ects of EECP, we do know that the procedure increases oxygenation of the myocardium via immediate improvement in central hemodynamics while promoting coronary collateral growth over time 4 . For the patient, this translates into symptom improvement soon after initiation of treatment, which can last up to five years 4 . More recent evidence suggests an even more intricate mechanism: many of the long-term benefits of EECP seem to be due to the improvement in peripheral shear stress secondary to changes in blood flow that results in widespread alterations in endothelial-derived vasoactive agents, proinflammatory cytokines and markers of antioxidant capacity 5 . These systemic e˜ects lead to the partial reversal of the endothelial dysfunction that characterizes coronary artery disease and atherosclerosis 5 . When coupled with an emphasis on compassionate, personal- ized care, the nature of the EECP treatment course — with its 35, one-hour sessions carried out five days a week over a span of seven weeks — o˜ers unique opportunities for Legacy Heart Care to further improve the lives of individuals and to address a public health challenge by providing the crucial intervention of chronic disease management education. With the vision of ultimately reducing chronic disease burden and healthcare costs, Legacy Heart Care developed its integrated Health & Wellness program — a multifaceted, patient education program designed S T R E N G T H E N I N G H E A R T S , E M P O W E R I N G L I V E S :

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