Enhanced External Counter Pulsation Therapy
How It Works
EECP is a non-pharmacological intervention that has been shown to reduce angina symptoms, lower nitrate use, improve exercise tolerance, and alleviate myocardial ischemia in refractory angina patients. It enhances retrograde shear stress in the femoral artery and antegrade-laminar shear stress in the brachial artery, promoting flow-mediated dilation. Research highlights improved peripheral arterial dilation and endothelial vasoactive function in coronary artery disease patients.
EECP also enhances endothelial function, reduces angina attacks, and improves quality of life in patients with left ventricular dysfunction by lowering central blood pressure and myocardial oxygen demand. It supports walking distance improvement in peripheral artery disease and mitigates hypertensive vascular injury by restoring endothelial function. While antianginal drugs are a cornerstone of therapy, non-pharmacological treatments like EECP, cognitive behavioral therapy, and cardiac sympathetic denervation have proven valuable, particularly in combination approaches. EECP is cost-effective and shows potential in managing atherosclerosis through hemodynamic effects on carotid artery plaque.
Recent Advancements
Recent advancements in EECP therapy have improved its effectiveness, accessibility, and patient experience. These include patient-specific computational fluid dynamics to enhance hemodynamic effects and endothelial function. Sharma et al.’s trial explored EECP’s use in severe intracranial steno-occlusive disease, showing potential beyond traditional cardiovascular applications by reducing stroke risk and improving blood flow in patients with severe intracranial stenosis.
Chen et al’s study emphasized tailoring EECP frequency for coronary heart disease and cerebral ischemic stroke, highlighting personalized treatment. Technological progress has also introduced portable EECP devices and complex pulse sequences, enabling treatment for various conditions like cognitive disorders and diabetes while improving convenience and effectiveness.