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Therapeutic effects of Enhanced External Counter Pulsation (EECP) on clinical symptoms, echocardiographic measurements, perfusion scan parameters and exercise tolerance test in coronary artery disease patients with refractory angina

Fariba Eslamian, Naser Aslanabadi, Babak Mahmoudian, Seyyed Kazem Shakouri.




Abstract

Background: The purpose of this study was finding relationship between the therapeutic effects of Enhanced External Counterpulsation on treatment resistant angina among the patients, who are unsuitable for invasive interventions.

Materials and methods: In an interventional study 50 patients (34 men and 16 women) under EECP therapy were investigated for one year. This machine is composed of three pairs of cuffs which work by attaching cuffs to lower limbs and it is contracted during diastole from distal to proximal and makes pressure to vessels of lower limbs. Treatment effects of EECP on clinical signs were evaluated on the base of Canadian cardiovascular society classification for angina severity, drugs consumption and SF36 quality of life questionnaire. Para clinical assessments including echocardiography, perfusion scan and exercise tolerance test parameters were also assessed prior to EECP, at the end of the treatment and at 12 months thereafter. Any differences in background measurements were recorded and analyzed.

Results: Decrement of angina severity and improvement of life quality before and after one month EECP therapy was significant (p0.05). There was significant difference between ejection fraction of before, one month and one year after treatment only in severe IHD (p=0.016, p=0.038, respectively). Left ventricle end diastolic and end systolic diameters were also significantly decreased after one month (p= 0.031), and this improvement remained up to one year. Difference between ischemia severity in perfusion scan before and one month afterwards was significant as well (p= 0.044). The exercise tolerance test duration after one month also increased (p

Key words: Enhanced External Counter Pulsation (EECP), refractory angina, Coronary Artery Disease, coronary artery bypass grafting surgery, Ischemia






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