PM&R
Volume 1, Issue 3 , Pages 268-276 , March 2009

Enhanced External Counterpulsation: An Innovative Physical Therapy for Refractory Angina

Received 13 August 2008 ,Accepted 4 December 2008.

References 

  1. American Heart Association. Heart Disease and Stroke Statistics—2008 Update. Dallas, TX: American Heart Association; 2008;
  2. McGillion M, Arthur H, Andrell P, Watt-Watson J. Self management training in refractory angina. BMJ. 2008;336:338–339
  3. Manchanda A, Soran O. Enhanced external counterpulsation and future directions: Step beyond medical management for patients with angina and heart failure. J Am Coll Cardiol. 2007;50:1523–1531
  4. Soran O, Demarca T, Crawford L, et al. Efficacy and safety of enhanced external counterpulsation in mild to moderate heart failure: A preliminary report. J Cardiac Failure. 1999;5(3 Suppl 1):53;(195)
  5. Soran O, Fleishman B, Demarco T, et al. Enhanced external counterpulsation in patients with heart failure: A multi-center feasibility study. Congest Heart Fail. 2002;8:204–208
  6. Soran O, Kennard ED, Kelsey SF, Holubkov R, Strobeck J, Feldman AM. Enhanced external counterpulsation as treatment for chronic angina in patients with left ventricular dysfunction: A report from the International EECP Patient Registry (IEPR). Congest Heart Fail. 2002;8:297–302
  7. Feldman AM, Silver MA, Francis GS, et al. Enhanced external counterpulsation improves exercise tolerance in patients with chronic heart failure. J Am Coll Cardiol. 2006;48:1198–1205
  8. Michaels AD, Accad M, Ports TA, Grossman W. Left ventricular systolic unloading and augmentation of intracoronary pressure and Doppler flow during enhanced external counterpulsation. Circulation. 2002;106:1237–1242
  9. Stys TP, Lawson WE, Hui JCK, et al. Effects of enhanced external counterpulsation on stress radionuclide coronary perfusion and exercise capacity in chronic stable angina pectoris. Am J Cardiol. 2002;89:822–824
  10. Zhang Y, He X, Chen X, et al. Enhanced external counterpulsation inhibits intimal hyperplasia by modifying shear stress responsive gene expression in hypercholesterolemic pigs. Circulation. 2007;116:526–534
  11. Akhtar M, Wu GF, Du ZM, Zheng ZS, Michael AD. Effect of external counterpulsation on plasma nitric oxide and endothelin-1 levels. Am J Cardiol. 2006;98:28–30
  12. Bonetti PO, Barsness GW, Keelan PC, et al. Enhanced external counterpulsation improves endothelial function in patients with symptomatic coronary artery disease. J Am Coll Cardiol. 2003;41:1761–1768
  13. Nichols WW, Estrada JC, Braith RW, Owens K, Conti CR. Enhanced external counterpulsation treatment improves arterial wall properties and wave reflection characteristics in patients with refractory angina. J Am Coll Cardiol. 2006;48:1208–1214
  14. Casey DR, Conti CR, Nichols WW, Choi CY, Khuddus MA, Braith RW. Effect of enhanced external counterpulsation on inflammatory cytokines and adhesion molecules in patients with angina pectoris and angiographic coronary artery disease. Am J Cardiol. 2008;101:300–302
  15. Barsheshet A, Hod H, Shechter M, et al. The effect of external counter pulsation therapy on circulating endothelial progenitor cells in patients with angina pectoris. Cardiology. 2008;110:160–166
  16. Zheng ZS, Li TM, Kambic H, et al. Sequential external counterpulsation (SECP) in China. Trans Am Soc Artif Intern Organs. 1983;29:599–603
  17. Lawson WE, Hui JC, Soroff HS, et al. Efficacy of enhanced external counterpulsation in the treatment of angina pectoris. Am J Cardiol. 1992;70:859–862
  18. Lawson WE, Hui JC, Zheng ZS, et al. Improved exercise tolerance following enhanced external counterpulsation: Cardiac or peripheral effect?. Cardiology. 1996;87:271–275
  19. Lawson WE, Hui JC, Zheng ZS, et al. Can angiographic findings predict which coronary patients will benefit from enhanced external counterpulsation?. Am J Cardiol. 1996;77:1107–1109
  20. Lawson WE, Hui JCK, Guo T, Burger L, Cohn PF. Prior revascularization increases the effectiveness of enhanced external counterpulsation. Clin Cardiol. 1998;21:841–844
  21. Arora RR, Chou TM, Jain D, et al. The Multicenter Study of Enhanced External Counterpulsation (MUST-EECP): effect of EECP on exercise-induced myocardial ischemia and anginal episodes. J Am Coll Cardiol. 1999;33:1833–1840
  22. Lawson WE, Hui JCK, Cohn PF. Long-term prognosis of patients with angina treated with enhanced external counterpulsation: five-year follow-up study. Clin Cardiol. 2000;23:254–258
  23. Lawson WE, Hui JCK, Lang G. Treatment benefit in the enhanced external counterpulsation consortium. Cardiology. 2000;94:31–35
  24. Urano H, Ikeda H, Ueno T, Matsumoto T, Murohara T, Imaizumi T. Enhanced external counterpulsation improves exercise tolerance, reduces exercise-induced myocardial ischemia, and improves left ventricular diastolic filling in patients with coronary artery disease. J Am Coll Cardiol. 2001;37:93–99
  25. Masuda D, Nohara R, Hirai T, et al. Enhanced external counterpulsation improved myocardial perfusion and coronary flow reserve in patients with chronic stable angina; Evaluation by(13)N-ammonia positron emission tomography. Eur Heart J. 2001;22:1451–1458
  26. Stys T, Lawson WE, Hui JC, Lang G, Liuzzo J, Cohn PF. Acute hemodynamic effects and angina improvement with enhanced external counterpulsation. Angiology. 2001;52:653–658
  27. Barsness G, Feldman AM, Holmes DR, Holubkov R, Kelsey SF, Kennard ED. The International EECP Patient Registry (IEPR): Design, methods, baseline characteristics, and acute results. Clin Cardiol. 2001;24:435–442
  28. Fitzgerald CP, Lawson WE, Hui JCK, Kennard ED IEPR Investigators. Enhanced external counterpulsation as initial revascularization treatment for angina refractory to medical therapy. Cardiology. 2003;100:129–135
  29. Tartaglia J, Stenerson J, Charney R, et al. Exercise capability and myocardial perfusion in chronic angina patients treated with enhanced external counterpulsation. Clin Cardiol. 2003;26:287–290
  30. Lawson WE, Silver MA, Hui JC, Kennard ED, Kelsey SF. Angina patients with diastolic versus systolic heart failure demonstrate comparable immediate and one-year benefit from enhanced external counterpulsation. J Card Fail. 2005;11:61–66
  31. Lawson WE, Hui JC, Kennard ED, Kelsey SF, Michaels AD, Soran O International Enhanced External Counterpulsation Patient Registry Investigators. Two-year outcomes in patients with mild refractory angina treated with enhanced external counterpulsation. Clin Cardiol. 2006;29:69–73
  32. Novo G, Bagger JP, Carta R, Koutroulis G, Hall R, Hihoyannopoulos P. Enhanced external counterpulsation for treatment of refractory angina pectoris. J Cardiovasc Med. 2006;7:335–339
  33. Loh PH, Louis AA, Windram J, et al. The immediate and long-term outcome of enhanced external counterpulsation in treatment of chronic stable refractory angina. J Intern Med. 2006;259:276–284
  34. Pettersson T, Bondesson S, Cojocaru D, Ohlsson O, Wackenfors A, Edvinsson L. One year follow-up of patients with refractory angina pectoris treated with enhanced external counterpulsation. BMC Cardiovasc Disord. 2006;6:28
  35. Soran O, Kennard ED, Bart BA, Kelsey SF IEPR Investigators. Impact of external counterpulsation treatment on emergency department visits and hospitalizations in refractory angina patients with left ventricular dysfunction. Congest Heart Fail. 2007;13:36–40
  36. Loh PH, Cleland JG, Louis AA, et al. Enhanced external counterpulsation in the treatment of chronic refractory angina: A long-term follow-up outcome from the International Enhanced External Counterpulsation Patient Registry. Clin Cardiol. 2008;31:159–164
  37. Arora RR, Chou TM, Jain D, et al. Effects of enhanced external counterpulsation on health-related quality of life continue 12 months after treatment: A substudy of the multicenter study of enhanced external counterpulsation. J Invest Med. 2002;50:25–32
  38. Michaels AD, McCullough PA, Soran OZ, et al. Primer: practical approach to the selection of patients for and application of EECP. Nat Clin Pract Cardiovasc Med. 2006;3:623–632
  39. Gibbons RJ, Abrams J, Chatterjee K, et al. ACC/AHA 2002 guideline update for the management of patients with chronic stable angina—summary article: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients with Chronic Stable Angina). Circulation. 2003;107:149–158
  40. Braverman DL. Heal Your Heart with EECP. Berkeley, CA: Celestial Arts; 2005;

 Disclosure Key can be found on the Table of Contents and at www.pmrjournal.org

PII: S1934-1482(08)00042-7

doi: 10.1016/j.pmrj.2008.12.002

PM&R
Volume 1, Issue 3 , Pages 268-276 , March 2009

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