The Effect of Enhanced External Counterpulsation (EECP) on Quality of life in Patient with Coronary Artery Disease not Amenable to PCI or CABG

Abstract

Enhanced External Counterpulsation (EECP) is a non-invasive FDA approved therapy for patients with refractory angina pectoris. The EECP mechanism of action is similar to that of an intra-aortic balloon pump (IABP) by administering a vigorous pressure pulse via external blood pressure cuffs during the diastole. The benefit of EECP includes improvement in angina severity, angina stability, maximal walking capacity and generalized improvement in overall health. Seatle Angina Questionnaire (SAQ) is a valid, reliable and sensitive measure of healthrelated quality of life. It is also a sensitive and reproducible evaluation tool to measure the response to an intervention. We did a pre-test post-test designed prospective study to evaluate the effect of EECP on the quality of life in patients with CAD. There was a significant difference between SAQ-7 health-related quality of life between the pre-EECP and post-EECP groups (P value= <0.01). Moreover, a positive correlation was reported between the New York Heart Association (NYHA) Functional Classification before treatment and post-EECP SAQ-7 healthrelated quality of life (P value=0.015).

The Endothelium as a Therapeutic Target in Diabetes: A Narrative Review and Perspective

“…The beneficial effects of EECP have expanded to peripheral artery disease, diabetes, erectile dysfunction, and possibly Alzheimer’s disease. Similar to exercise, EECP adds additional pulsations to the endothelium, which have been shown to induce production of nitric oxide ( Akhtar et al, 2006 ), improve flow mediated vasodilation (FMD) endothelial function ( Shechter et al, 2003 ; Braith et al, 2010 ), attenuate pro-inflammatory signaling pathways ( Zhang et al, 2010 ; Martin and Braith, 2012 ) and improve quality of life ( Jan et al, 2020 ) amongst others. The mechanisms for the effects produced by EECP appear to have both a central hemodynamic component with decreased afterload, increased coronary blood flow, and a peripheral effect (passive exercise) ( Braith et al, 2012 ; Raza et al, 2017 ).…”

Ranolazine for improving coronary microvascular function in patients with nonobstructive coronary artery disease: a systematic review and meta-analysis with a trial sequential analysis of randomized controlled trials

“…As an adjunct to pharmacological therapy, EECP fosters the development of coronary collateral vessels, boosting CFR in patients with refractory angina ( 44 , 45 ). Importantly, EECP has been shown to significantly improve patients’ quality of life, with sustained benefits noted in clinical follow-ups ranging from 3 months to 2 years posttreatment ( 46 , 47 ). This underscores the potential for multimodal treatment strategies incorporating both ranolazine and EECP to enhance symptom management and quality of life in patients with refractory angina.…”

The Effect of Enhanced External Counterpulsation on the Vascular State, Indicators of Glycemic Control and Quality of Life in Patients with Coronary Artery Disease and Type 2 Diabetes Mellitus

“…Положительное влияние УНКП на клинический статус больных и качество жизни было неоднократно подтверждено в проведенных ранее исследованиях [1,2,16]. Результаты нашей работы свидетельствуют о том, что эффективность УНКП в отношении влияния на качество жизни применима также к группе больных с ИБС и СД 2 типа.…”

“…Усиленная наружная контрпульсация (УНКП) -неинвазивный и безопасный метод лечения стабильной ишемической болезни сердца (ИБС), в том числе, при наличии изменений коронарного русла, которые не позволяют провести реваскуляризацию. [1]. В последние годы наметилась тенденция к расширению спектра показаний для применения метода.…”