- © 2013 Marshfield Clinic
The Role of Enhanced External Counter Pulsation Therapy in Clinical Practice
- Umesh Sharma, MD, FACP*,
- Heidi K. Ramsey, BS, RCEP† and
- Tahir Tak, MD, PhD, FACC‡⇑
- *Department of Hospital Medicine, Mayo Clinic Health System-Franciscan Healthcare, La Crosse, WI
- †Department of Cardiac Rehab, Mayo Clinic Health System-Franciscan Healthcare, La Crosse, WI
- ‡Department of Cardiology, Mayo Clinic Health System-Franciscan Healthcare, La Crosse, WI and Cardiovascular Diseases, Mayo Clinic, Rochester, MN
- Corresponding Author: Tahir Tak, MD, PhD, FACC; Division of Cardiovascular Services; Mayo Clinic; 200 First Street, SW; Rochester, MN 55905; Tel: 507-284-2941; Fax: 608-392-7881; Email: tak.tahir{at}mayo.edu
Abstract
Enhanced external counterpulsation (EECP) has been approved by the United States Food and Drug Administration (FDA) for management of refractory angina (Class IIb). EECP uses three sets of pneumatic cuffs that sequentially contract during diastole, increasing aortic diastolic pressure, augmenting coronary blood flow and central venous return. EECP improves anginal symptoms and exercise tolerance, and reduces nitroglycerin use in patients with chronic, stable angina. EECP has also been shown to be safe and beneficial in patients with symptomatic stable congestive heart failure. It has been postulated that cardiac benefits of EECP are mediated though vascular endothelial growth factor (VEGF) and nitric oxide mediated vasodilatation and angiogenesis. In June 2002, the FDA also approved EECP therapy for heart failure patients.
