The safety and efficacy of compression therapy in patients with stable heart failure

Int J Cardiol Heart Vasc. 2024 Jan 21:50:101343. doi: 10.1016/j.ijcha.2024.101343. eCollection 2024 Feb.

Abstract

Background: Compression therapy is widely used as a therapeutic option for edema; however, concerns regarding its safety in patients with heart failure (HF) arose, particularly due to increased venous return, which increases pulmonary artery blood pressure. This study aimed to investigate the safety of compression therapy in patients with chronic HF.

Methods: This study retrospectively enrolled patients with stable chronic HF who initiated treatment with compression therapy for lower extremity edema. The primary outcome was New York Heart Association (NYHA) class changes after 1 month of compression therapy, and adverse events were evaluated.

Results: We analyzed 101 patients who initiated compression therapy. The number of patients continuing compression therapy at one month was 86. Overall, 61.6 % were female and the median age was 81 years. The proportion of patients with heart failure and preserved ejection fraction (HFpEF) was 50.4 %. Brain natriuretic peptide levels were significantly lower than baseline levels at 1 month, (baseline vs 1 month: 486 (360-696) vs 311 (211-511), p < 0.001), with a lower NYHA III prevalence (baseline vs 1 month: 53.5 % vs 32.6 %, p < 0.001), without any adverse events related to compression therapy initiation. Additionally, multivariate logistic analysis indicated an association between HFpEF and significant BNP reduction after compression therapy (odds ratio: 4.70; 95 % confidence interval: 1.63-13.6).

Conclusions: Compression therapy was associated with decreased BNP levels and improved symptoms, especially in HFpEF, without any adverse events in stable chronic HF. These findings indicate that compression therapy is safe for patients with stable chronic HF.

Keywords: Leg compression therapy; Lymphatic dysfunction; Venous dysfunction.