The role of enhanced external counterpulsation in the treatment of angina and heart failure

Arora, Rohit; Shah, Ankur

doi:10.1016/s0828-282x(07)70826-7

Cited by 8 publications

(5 citation statements)

References 24 publications

(27 reference statements)

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“…Of these modalities enhanced external counterpulsion (EECP) therapy represents the most effective non-invasive technique (6). Furthermore, the role of EECP therapy has been recently investigated for the treatment of HF (7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

Clinical effects of enhanced external counterpulsation treatment in patients with ischemic heart failure

Kozdağ¹,

Ertaş²,

Aygün³

et al. 2012

Anadolu Kardiyol Derg

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Objective: Enhanced external counterpulsation (EECP) is a noninvasive treatment that is proven safe and effective in patients with coronary artery disease (CAD) and heart failure (HF). The aims of this study are to investigate the clinical effects of EECP therapy in patients with symptomatic CAD and chronic HF, and to find out an answer to the question: Does EECP therapy have any effect on the prognostic markers of HF? Methods: This study was designed as a prospective cohort study. A total of 68 consecutive patients with symptomatic CAD and chronic HF referred to EECP therapy were enrolled in this study between November 2007 and December 2010; 47 patients (39 males and 8 females, 65±7, years), have undergone EECP treatment, and 21 patients (20 males and 1 female, 62±10 years), who did not want to participate in the EECP program comprised the control group. Statistical analysis was performed using t tests for dependent and independent samples, Mann-Whitney U test, Chi-square and Fischer exact tests. Results: EECP therapy resulted in significant improvement in post-intervention New York Heart Association functional class (p<0.001), left ventricular ejection fraction (p<0.001), B-type natriuretic peptide levels (p<0.003), uric acid levels (p<0.05), free-T3/free-T4 ratio (p<0.034) and mitral annular E (p<0.05) velocity, compared with baseline, a finding not evident in the control group. Conclusion: EECP treatment significantly improved clinical and some biochemical parameters, which are mostly prognostic markers in patients with symptomatic CAD and chronic HF. (Anadolu Kardiyol Derg 2012; 12: 214-21)

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Section: Introductionmentioning

confidence: 99%

Clinical effects of enhanced external counterpulsation treatment in patients with ischemic heart failure

Kozdağ¹,

Ertaş²,

Aygün³

et al. 2012

Anadolu Kardiyol Derg

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“…One thousand and ninety‐seven patients from the International EECP Patient Registry also showed a significant improvement in quality of life parameters after 2 years 29 . Approximately 41% of patients also remained event‐free during this 2‐year period, and nitroglycerine use remained significantly decreased compared with baseline 26,29 …”

Section: Resultsmentioning

confidence: 93%

“…At 2‐year follow‐up , 70% of class III‐IV patients continued to demonstrate a durable CCS class improvement over baseline and remained free of major adverse cardiovascular events (MACE) 28 . One thousand and ninety‐seven patients from the International EECP Patient Registry also showed a significant improvement in quality of life parameters after 2 years 29 . Approximately 41% of patients also remained event‐free during this 2‐year period, and nitroglycerine use remained significantly decreased compared with baseline 26,29 …”

Section: Resultsmentioning

confidence: 99%

Enhanced external counterpulsation: A unique treatment for the “No‐Option” refractory angina patient

et al. 2021

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What is known and objectives Coronary artery disease (CAD) is the leading cause of death in the United States. For patients on whom guideline‐driven measures have been tried, enhanced external counterpulsation (EECP) is the only truly noninvasive and safe intervention for which a reduction of angina symptoms and nitrate use, increased exercise tolerance, and improvement in myocardial ischaemia have been shown. The objective of this study was to demonstrate, by way of literature review, the efficacy of EECP as a treatment modality for the relief of refractory angina and improvement in quality of life in CAD patients. Methods This article reviewed the safety and efficacy of EECP in patients with refractory angina, by conducting a sweeping search and analysis of existing published literature. Results and Discussion Critical review of a multitude of studies revealed that EECP consistently reduces angina pectoris, extends time to exercise‐induced ischaemia, decreases dependency on nitroglycerine for frequent chest pain, increases maximum workload, and improves the quality of life in patients with symptomatic stable angina. The literature reviewed also indicated that EECP is well‐tolerated by the vast majority of patients, with relatively few adverse events reported. Conclusion The present study suggests that EECP is a safe and likely best available method of treatment for patients presenting with symptomatic CAD not amenable to further revascularization.

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“…The rapid deflation of the cuffs at the onset of systole also serves to reduce vascular resistance, causing a reduction in cardiac workload. 22 The combined effect is analogous to that of an intra-aortic balloon pump (IABP), albeit in a non-invasive fashion.…”

Section: Enhanced External Counterpulsation (Eecp)mentioning

confidence: 99%

“…A number of theories have been postulated, which predominantly pertain to two closely intertwined concepts; improved endothelial function and augmented angiogenesis. 22 The raised diastolic pressure resultant from EECP has been demonstrated to be associated with increased shear stress, which can stimulate pro-angiogenic factors such as the potent vasodilator nitric oxide (NO) and vascular endothelial growth factor (VEGF). 28,29 The subsequent increase in angiogenesis is hypothesised to be responsible for increased collateral formation within the coronary circulation.…”

Section: Enhanced External Counterpulsation (Eecp)mentioning

confidence: 99%

Non-Pharmacological Interventions in Refractory Angina

Ali¹,

Patel²

2018

Heart Res Open J

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Refractory angina (RA) is defined by intractable cardiac chest pain despite standard medical therapy and revascularisation. Symptoms are associated with significant morbidity and compromised quality of life (QoL). Various methods of interventional pain management can be considered for the complex care of these cohorts. This review explores postulated mechanisms and evidence base underpinning therapeutic strategies such as cognitive behavioural therapy (CBT), cardiac rehabilitation, stellate ganglion blockade (SGB), enhanced external counterpulsation (EECP) and coronary sinus reducer (CSR) implantation. Use of these modalities is dependent on the local provision, but suitability is best assessed by specialist RA services using an individualised, multidisciplinary framework.

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The role of enhanced external counterpulsation in the treatment of angina and heart failure

Cited by 8 publications

References 24 publications

Clinical effects of enhanced external counterpulsation treatment in patients with ischemic heart failure

Clinical effects of enhanced external counterpulsation treatment in patients with ischemic heart failure

Enhanced external counterpulsation: A unique treatment for the “No‐Option” refractory angina patient

Non-Pharmacological Interventions in Refractory Angina

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