Enhanced external counterpulsation for ischemic heart disease: what's behind the curtain?
نویسندگان
چکیده
Enhanced external counterpulsation (EECP) has been shown to reduce angina and to improve objective measures of myocardial ischemia in patients with refractory angina. Prospective clinical studies and large treatment registries suggest that a course of EECP is associated with prolongation of the time to exercise-induced ST-segment depression and resolution of myocardial perfusion defects, as well as with enhanced exercise tolerance and quality of life. With a growing knowledge base supporting the safety and beneficial clinical effects associated with EECP, this therapy can be considered a valuable treatment option, particularly in patients who have exhausted traditional revascularization methods and yet remain symptomatic despite optimal medical care. However, although the concept of external counterpulsation was introduced almost four decades ago, and despite growing evidence supporting the clinical benefit and safety of this therapeutic modality, little is firmly established regarding the mechanisms responsible for the beneficial effects associated with this technique. Suggested mechanisms contributing to the clinical benefit of EECP include improvement in endothelial function, promotion of coronary collateralization, enhancement of ventricular function, peripheral effects similar to those observed with regular physical exercise, and nonspecific placebo effects. This review summarizes the current evidence for a contribution of these mechanisms to the clinical benefit associated with EECP.
منابع مشابه
The Effects of Enhanced External Counterpulsation on Cardiac Electrophysiologic Properties of Patients with Ischemic Heart Disease and Refractory Angina at Function Class II-III.
INTRODUCTION Enhanced external counterpulsation (EECP) is a noninvasive circulatory assist device that has been recently emerged as a treatment option for refractory angina or left ventricular (LV) dysfunction. The aims of this study were to examine the effects of EECP on the elecrocardiographic parameters and the heart rate variability indices of patients with the coronary heart disease and fu...
متن کاملClinical Practice of EECP in Non-Cardiac Disease in China
Introduction Enhanced external counterpulsation is a technique using a set of cuffs that are wrapped around the lower part of the body. During treatment, pressure is sequentially applied via the cuffs to the lower extremities of the patient synchronized by cardiac cycle. At early diastole, pressure is applied sequentially from the lower legs to the lower and upper thighs, to propel blood back t...
متن کاملPsychosocial effects of enhanced external counterpulsation in the angina patient: a second study.
Enhanced external counterpulsation (EECP) is a noninvasive technique that has shown promise in the treatment of ischemic coronary artery disease. Patients undergoing EECP were tested for alterations in psychosocial state associated with treatment. Overall perception of health and quality of life improved with EECP. There was also significant improvement in levels of depression, anxiety, and som...
متن کاملTreating heart failure with enhanced external counterpulsation (EECP): design of the Prospective Evaluation of EECP in Heart Failure (PEECH) trial.
BACKGROUND Enhanced external counterpulsation (EECP) treatment can improve exercise tolerance in patients with ischemic heart disease; however, the possible benefits of EECP in patients with stable heart failure (HF) and left ventricular dysfunction (LVD) are unclear. An open pilot study showed significant increases in exercise tolerance in HF patients undergoing EECP. Thus a larger, controlled...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Journal of the American College of Cardiology
دوره 41 11 شماره
صفحات -
تاریخ انتشار 2003