The Effects of Enhanced External Counter Pulsation on Heart Function in Patients with Ischemic Heart Disease and Left Ventricular Dysfunction

Enhanced external counter pulsation (EECP) is used to reduce chest pain in patients with refractory angina. However, there is controversy about the effects of this method on heart failure. This study aimed to evaluate the efficacy of EECP in treatment of patients with coronary artery disease and left ventricular dysfunction.

In this cross-sectional study, 30 patients with ischemic heart disease (28 men, 55 ± 10 years old) who had a left ventricular ejection fraction (LVEF) of less than 35% were evaluated for the effects of EECP. The therapeutic protocol was 35 one-hour daily sessions which were held 5 days a week for 7 weeks. The data were analyzed using paired t-test at a significance level of P < 0.05.

Significant improvements were observed in LVEF, wall motion abnormality, fractional shortening, and left ventricular end-systolic internal dimension. Moreover, the incidence of angina pectoris significantly decreased and functional class showed significant improvement after the intervention. However, left ventricular end-diastolic internal dimension, the ratio of early diastolic mitral flow velocity/late diastolic mitral flow velocity, and the need for nitroglycerin did not improve. Meanwhile, psychological factors including depression, anxiety state, and mental and physical quality of life showed significant improvements.

In our study, EECP improved left ventricular systolic function, frequency of angina, functional class, and quality of life by decreasing anxiety and depression. Further studies about the effects of EECP in ischemic heart failure are recommended.