21 Mar Why EECP treatment?
EECP (enhanced external counterpulsation) is a mechanical type of angina therapy for chest pain.
What Is EECP?
EECP is a mechanical operation that involves wrapping long inflatable cuffs (similar to blood pressure cuffs) across each of the patient’s ankles. The leg cuffs are inflated and deflated synchronously for each pulse when the patient is lying on a bed.
A machine controls the inflation and deflation by using the patient’s electrocardiogram (ECG) to cause inflation early in diastole (when the heart relaxes and fills with blood) and deflation only when systole (heart contraction) starts.
The cuffs are inflated sequentially, from the lower to the upper portion of the legs, so that the blood in the legs is “milked” upwards, into the middle.
EECP has at least two possible heart-beneficial effects
First, during diastole, the milking operation of the leg cuffs stimulates blood supply to the coronary arteries. (In contrast to other arteries, coronary arteries receive blood supply during heartbeats rather than after them.
Second, by deflating right before the heart starts to pound, EECP produces a rapid vacuum in the lungs, minimizing the amount of work needed by the heart muscle to pump blood. It is also thought that EECP can aid in the reduction of endothelial dysfunction.
EECP can also enhance peripheral arterial control, reducing myocardial oxygen demand.
How Effective Is EECP?
Several reports show that EECP may be very successful in the management of recurrent stable angina.
In a limited randomized study, EECP dramatically increased both angina symptoms (a subjective measure) and workout resistance (a more objective measure) in people with CAD. In addition, EECP greatly increased quality-of-life outcomes as opposed to placebo treatment.
Other research also shown that the relief of symptoms after a course of EECP will last for up to five years (though 1 in 5 patients may require another course of EECP to maintain their improvement).
How Does EECP Work?
The process behind the obvious long-term gains shown with EECP remains unclear. Any research indicates that EECP can promote the production of nitric oxide and other growth factors inside the coronary arteries, which can assist in the development of collateral vessels in the coronary artery tree.
There is also proof that EECP may function as a kind of “passive” exercise, inducing the same forms of long-term beneficial improvements in the autonomic nervous system as actual exercise.