Key result
Diaphragm graft operation improved exercise tolerance and rate-pressure index in 29% of surviving patients at 1 year, compared to 14% of those treated with the Beck method.
Why the study?
Does the diaphragm graft operation improve exercise tolerance compared to the Beck method in male patients with angina pectoris?
RCT (n=43)
randomized
Does the diaphragm graft operation improve exercise tolerance compared to the Beck method in male patients with angina pectoris?
Absolute Event Rate: 29% vs 14%
The diaphragm graft operation resulted in a slightly higher rate of improved exercise tolerance compared to the Beck method at 1 year, though overall improvement rates were low for both surgical techniques.
Diaphragm graft modestly outperforms Beck for exercise tolerance; extends RCT evidence on angina surgery but low absolute gains limit adoption.
Graded exercise tests with ECG-recording were performed on 43 male patients evaluated before randomized surgery, aimed at improving the myocardial vascul-arization with the Beck method (18 cases) or the diaphragm graft operation (25 cases). Before surgery the ECG-findings at rest and after exercise were indicative of ischemic heart disease in 80% of the cases and anginal pain was provoked in all but 3 patients during exercise (93%). The exercise tolerance, heart rates, systolic blood pressures and rate-pressure products before surgery in the two groups were identical. Four patients in each group died before a 1 year follow-up study could be performed. Comparison between pre- and postoperative findings among the 35 survivors showed a general reduction in all variables in both groups, most pronounced in the Beck group. Six patients out of 21 (29%) in the graft group were improved in exercise tolerance and rate-pressure index, in the Beck group there were only 2 out of 14 (14%) with increased exercise tolerance after surgery. The improvement is thought to be due to better vascularization and secondarily improved myocardial function (4 graft cases), improved physical fitness obtained by increased physical activity (training) (2 Beck cases); increased pain threshold by necrosis of pain-sensitive areas of the myocardium (2 graft cases).
No takes yet. Share an insight, caveat, or question.
Lecerof et al. (1972) conducted an RCT in Angina Pectoris (n=43). Diaphragm graft operation vs. Beck method was evaluated on Improved exercise tolerance and rate-pressure index. Diaphragm graft operation improved exercise tolerance and rate-pressure index in 29% of surviving patients at 1 year, compared to 14% of those treated with the Beck method.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: