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ECP Scholarly Article

Coronary Collateral Growth by External Counterpulsation: A Randomised Controlled Trial

ECP appears to be effective in promoting coronary collateral growth. The extent of collateral function improvement is related to the amount of improvement in the systemic endothelial function.

Steffen Gloekler, Pascal Meier, Stefano F de Marchi, et al. Heart 2010 96: 202-207

Enhanced External Counterpulsation Improves Peripheral Artery Flow-Mediated Dilation in Patients with Chronic Angina: A Randomized Sham-Controlled Study.

Mechanisms responsible for anti-ischemic benefits of enhanced external counterpulsation (EECP®) remain unknown. This was the first randomized sham-controlled study to investigate the extracardiac effects of EECP® on peripheral artery flow-mediated.

Braith RW, Conti CR, Nichols WW, Choi CY, Khuddus MA, Beck DT, Casey DP.Circulation. 2010 Oct 19;122(16):1612-20. Epub 2010 Oct 4.

Impact of External Counterpulsation Treatment on Emergency Department Visits and Hospitalizations in Refractory Angina Patients with Left Ventricular Dysfunction.

Patients with refractory angina and left ventricular (LV) dysfunction exert an enormous burden on health care resources primarily because of the number of recurrent emergency department (ED) visits and hospitalizations. Enhanced external.

Soran O, Kennard ED, Bart BA, Kelsey SF; IEPR Investigators.Congest Heart Fail. 2007 Jan-Feb;13(1):36-40. Erratum in: Congest Heart Fail. 2007 Mar-Apr;13(2):124.

Mechanisms and Evidence for The Role of Enhanced External Counterpulsation In Heart Failure Management

Balloon counterpulsation has gained widespread acceptance as a therapy for cardiogenic shock. However, over the past four decades a parallel method of noninvasive counterpulsation, enhanced external counterpulsation (EECP®), has been defined…

Silver MA.Curr Heart Fail Rep. 2006 Apr;3(1):25-32. Review.

Enhanced External Counterpulsation Treatment Improves Arterial Wall Properties and Wave Reflection Characteristics in Patients with Refractory Angina

EECP treatment reduces arterial stiffness and improves wave reflection characteristics in patients with refractory angina. These changes decrease LV afterload and myocardial oxygen demand and reduce the number of angina episodes, therefore enabling patients to participate in continuous exercise programs which in turn may provide long-term benefits and sustained improved quality of life…

Wilmer W. Nichols, Juan C. Estrada, Randy W. Braith, Karen Owens, C. Richard Conti J Am Coll Cardiol. 2006 Sep, 48 (6) 1208-1214.

Improvement of Fractional Flow Reserve and Collateral Flow By Treatment With External Counterpulsation (Art.Net.‐2 Trial)

In this study, we provide direct functional evidence for the stimulation of coronary arteriogenesis via ECP in patients with stable coronary artery disease. These data might open a novel noninvasive and preventive treatment avenue for patients with non‐acute vascular stenotic disease…

Buschmann, E.E., Utz, W., Pagonas, N., Schulz‐Menger, J., Busjahn, A., Monti, J., Maerz, W., Le Noble, F., Thierfelder, L., Dietz, R., Klauss, V., Gross, M., Buschmann, I. and (2009), European Journal of Clinical Investigation, 39: 866-875. doi:10.1111/j.1365-2362.2009.02192.x

Enhanced External Counterpulsation Improves Exercise Tolerance, Reduces Exercise-Induced Myocardial Ischemia and Improves Left Ventricular Diastolic Filling in Patients with Coronary Artery Disease

EECP treatment improves exercise tolerance and reduced myocardial ischemia by thallium scintigraphy in association with improved LV diastolic filling in patients with stable CAD…

Hisashi Urano, Hisao Ikeda, Takafumi Ueno, Takahiro Matsumoto, Toyoaki Murohara, Tsutomu Imaizumi J Am Coll Cardiol. 2001 Jan, 37 (1) 93-99.

Enhanced External Counterpulsation for Ischemic Heart Disease: A Look Behind the Curtain

Enhanced external counterpulsation (EECP) is a non-invasive treatment for coronary artery disease (CAD) patients who have angina pectoris that is refractory to pharmacotherapy and revascularization. The popular concept is that EECP may promote collateral development and improve myocardial perfusion. We hypothesize that improvements in peripheral arterial function are responsible for the clinical benefits of EECP.

Braith RW, Casey DP, Beck DT. Exerc Sport Sci Rev. 2012;40(3):145‐152. doi:10.1097/JES.0b013e318253de5e

Enhanced External Counterpulsation in the Treatment of Chronic Refractory Angina: A Long‐term Follow‐up Outcome from the International Enhanced External Counterpulsation Patient Registry

An EECP improves angina and quality of life immediately after a course of treatment. For most of the patients, these beneficial effects are sustained for 3 years…

Loh, P.H., Cleland, J.G., Louis, A.A., Kennard, E.D., Cook, J.F., Caplin, J.L., Barsness, G.W., Lawson, W.E., Soran, O.Z. and Michaels, A.D. (2008), Clin Cardiol, 31: 159-164. doi:10.1002/clc.20117

Enhanced External Counterpulsation Is Cost‐Effective in Reducing Hospital Costs in Refractory Angina Patients

Treatment of refractory angina patients with EECP resulted in improvement in angina and functional class accompanied by a sustained reduction in health care costs over 1 year of follow‐up…

Lawson, W.E., Hui, J.C., Kennard, E.D., Linnemeier, G. and (2015), Clin Cardiol, 38: 344-349. doi:10.1002/clc.22395

Effect of Enhanced External Counterpulsation Treatment on Renal Function in Cardiac Patien

The study demonstrated that EECP could improve long-term renal function in cardiac patients especially in cases with declined renal function or with high NT-proBNP…

Ruangkanchanasetr, P., Mahanonda, N., Raungratanaamporn, O. et al. BMC Nephrol 14, 193 (2013). https://doi.org/10.1186/1471-2369-14-193

Impact of Enhanced External Counterpulsation on Heart Failure Rehospitalization in Patients with Ischemic Cardiomyopathy

Heart failure (HF) affects millions of Americans and causes financial burdens because of the need for rehospitalization. For this reason, health care systems and patients alike are seeking methods to decrease readmissions. We assessed the potential for reducing…

Tecson, K. M., Silver, M. A., Brune, S. D., Cauthen, C., Kwan, M. D., Schussler, J. M., … & McCullough, P. A. (2016). The American journal of cardiology, 117(6), 901-905.