external counterpulsation and angina

Doug Skrecky (oberon@vcn.bc.ca)
Fri, 24 Jul 1998 22:22:46 -0700 (PDT)

Citations: 1-5


Lawson WE. Hui JC. Zheng ZS. Burgen L. Jiang L. Lillis O. Oster Z. Soroff H. Cohn P.
Department of Medicine, SUNY Health Sciences Center, Stony Brook 11794-8171, USA.
Improved exercise tolerance following enhanced external counterpulsation: cardiac or peripheral effect?. Source
Cardiology. 87(4):271-5, 1996 Jul-Aug. Abstract
The effect of treatment with enhanced external counterpulsation (EECP) on exercise hemodynamics and myocardial stress perfusion in 27 patients with chronic stable angina was studied. A majority (22/27 or 81%) of patients improved their exercise tolerance after EECP treatment, and a similar percentage (21/27 or 78%) of patients improved their radionuclide stress perfusion images. Post-EECP maximal exercise heart rate and blood pressure, while demonstrating a linear relation with exercise duration, did not increase significantly despite the increased exercise duration. This suggests that the increase in exercise duration after treatment with EECP is due to both improved myocardial perfusion and altered exercise hemodynamics. EECP therapy thus appears to exert a "training' effect, decreasing peripheral vascular resistance and the heart rate response to exercise. Coronary disease patients may improve their exercise tolerance after EECP because of both improved myocardial perfusion and a decrease in cardiac work load.


Kasliwal RR. Mittal S. Kanojia A. Bhatia ML. Kronzon I. Trehan N. Institution
Escorts Heart Institute, Okhla Road, New Delhi. Title
Sequential external counterpulsation: an adjunctive therapy for patients with chronic coronary artery disease and left ventricular dysfunction.
Indian Heart Journal. 48(2):150-4, 1996 Mar-Apr. Abstract
We assessed the clinical and haemodynamic improvement with 3 weeks of sequential external counterpulsation (SECP) therapy in 23 patients with chronic coronary artery disease (CAD) and left ventricular (LV) dysfunction who were refractory to maximal tolerated doses of medical therapy and in whom intervention or surgery was not contemplated. All patients were subjected to one-hour duration of SECP for 3 weeks. SECP is a new noninvasive tool which increases coronary artery filling utilizing external pressure in a sequential manner from calf to thigh. A detailed clinical and echocardiographic evaluation was done before and after the completion of therapy to assess the utility of SECP. There were 18 males and 5 females with a mean age of 53 years. On coronary angiography, 39 percent patients had single, 8.7 percent had double and 48 percent had triple vessel disease. Four patients had coronary artery bypass graft (CABG) surgery in the past. Out of all patients, 48 percent had diffuse or distal coronary artery disease which was considered not suitable for CABG, 22 percent were not willing for intervention and 30 percent had other systemic diseases making them unfit for surgery. After 3 weeks of SECP, the anginal frequency reduced from 9 episodes/week to 1 episode/week. Before SECP, 74 percent patients were in NYHA class III, whereas only 8.7 percent were class III symptomatic after SECP. All patients claimed symptomatic improvement of a mean of 6.8 +/- 1.4 on a visual analog scale of 1-10. After SECP, the LV diastolic dimensions reduced from 54.6 +/- 7 to 51 +/- 7 mm, systolic dimensions reduced from 40 +/- 8 to 36 +/- 8 mm and LVEF increased from 32.7 +/- 9 to 37.4 +/- 8.5 percent. In conclusion, 3 weeks of therapy with SECP produces significant improvement in symptomatic status and cardiac function in patients with chronic CAD and LV dysfunction, refractory to medical therapy.


Lawson WE. Hui JC. Zheng ZS. Burger L. Jiang L. Lillis O. Soroff HS. Cohn PF.
Department of Medicine, State University of New York at Stony Brook, USA. Title
Can angiographic findings predict which coronary patients will benefit from enhanced external counterpulsation?.
American Journal of Cardiology. 77(12):1107-9, 1996 May 15. Abstract
Enhanced external counterpulsation is an effective treatment for chronic angina. Theoretical considerations predict greatest benefit in patients with at least 1 patent conduit in this group of 50 patients (all of whom improved clinically). Improvement in radionuclide stress perfusion imaging was seen in 80% of treated patients and was inversely related to extent of coronary disease.


Fricchione GL. Jaghab K. Lawson W. Hui JC. Jandorf L. Zheng ZS. Cohn PF. Soroff H.
Department of Psychiatry and Behavioral Science, SUNY at Stony Brook, USA. Title
Psychosocial effects of enhanced external counterpulsation in the angina patient.
Psychosomatics. 36(5):494-7, 1995 Sep-Oct. Abstract
Enhanced external counterpulsation (EECP) is a noninvasive pantaloon device designed to increase coronary artery flow in the treatment of angina. This pilot study, conducted in 1992-1993, which used psychosocial testing pre- and posttreatment, yielded data suggesting that EECP is well tolerated psychosocially and produces improvement in the anginal syndrome. More comprehensive research is under way to test these preliminary conclusions.


Lawson WE. Hui JC. Zheng ZS. Oster Z. Katz JP. Diggs P. Burger L. Cohn CD. Soroff HS. Cohn PF.
Department of Cardiology, State University Health Sciences Center of New York (SUNY), Stony Brook 11794-8171, USA.
Three-year sustained benefit from enhanced external counterpulsation in chronic angina pectoris. Source
American Journal of Cardiology. 75(12):840-1, 1995 Apr 15.