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[eecpforum]

Microvascular angina is effectively treated with EECP therapy. There is significant reduction after treatment in CCS angina class and in inducible ischemia. The effect is durable with a low incidence of recurrent angina following treatment. The efficacy of EECP therapy in treating microvascular angina patients supports improvement in endothelial function as a potential mechanism of action. Due to its multiple modes of action, EECP therapy may have broad utility in treating angina refractory to usual medical therapy, whether due to epicardial or microvascular coronary disease. The improvement in severe chronic angina would be expected to decrease disability and reduce health care costs due to recurrent hospitalizations and catheterizations.

EECP therapy enhances quality-of-life by its very nature, a non-invasive, outpatient treatment virtually free of the need for a post-treatment recovery period. Patients can go on with their daily lives while deriving its therapeutic benefits. When repeat treatment is indicated it is not coupled with increased morbidity or mortality. Optimal therapeutic levels are not the harbingers of debilitating side effects, and side effects do not necessitate sub-therapeutic treatment levels.

To read the entire article click here http://www.vasomedical.com/newsletter/vol1_issue1.pdf

[HavinAHeartDay]

I am new to this EECP. I was diagnosed with Endothelial Dysfunction with Syndrome X about 2 years ago. I have had constantly increasing pain with more and more pain medication being prescribed to control it. I am running out of options for relief. The location in my city does not have anyone who can run the EECP machine.

I guess my question is how effective has the treatment been with patients who have this combination and is there anyone I can call and speak to them? My original diagnosis came from Dr. Sabrina Phillips at Mayo in Rochester.

Thank you,
Chris

[eecpforum]

Hi Chris:
This was a paper presented at the 2004 American College of Cardiology Conference on patients with microvascular angina successfully treated with EECP therapy. If you let me know your location I can tell you what practices or hospitals in your area provide EECP therapy.
Also see the first post's link to the newsletter that discusses microvascular angina.
Sincerely,
Tom Riedman, RN
Vasomedical, Inc

Control/Tracking Number : 04-A-292803-ACC
Long-term Improvement in Microvascular Angina Patients Treated With Enhanced External Counterpulsation


Kenneth D. Kronhaus, William E. Lawson, Lake Cardiology, Mount Dora, FL, SUNY Stony Brook, Stony Brook, NY

Background: Angina in patients without significant angiographic epicardial disease can be a medically refractory cause of chronic disability. For these microvascular angina patients Enhanced External Counterpulsation (EECP) may prove uniquely beneficial. Patent epicardial arteries facilitate transmission of the increased flow and pressure generated by EECP to the microcirulation and may promote angiogenesis, normalize endothelial function and improve myocardial perfusion and anginal symptoms. The benefit and durability of EECP therapy in these patients was studied.
Methods: Patients with typical angina refractory to medical therapy and evidence of microvascular angina (a pharmacologic or exercise stress test with radionuclide or echocardiographic imaging [ST] showing regional ischemia together with a cardiac angiogram demonstrating no significant coronary disease) were treated with EECP. Angina, assessed by the Canadian Cardiovascular Society class [CCS], and stress tests were evaluated at baseline and after completing EECP treatment. Major cardiovascular events (cardiac hospitalization, death, infarction) were tracked for the duration of follow-up. Statistical analysis was performed with the student t test; significance level p <0.05.
Results: Twenty one pts, 14 women and 7 men with a mean age of 68.5 years, received an average of 36.4 hours of EECP. CCS improved in all patients; the average baseline class of 3.8 improved to an early CCS of 1.4 [p< 0.05] and 6.3 month CCS of 1.2 [p<0.05]. ST obtained a mean of 5.0 months post EECP showed complete resolution of defects in 16/17 cases [p<0.05]. There was a durable reduction in angina in 20/21 patients at a mean 12.9 months of follow-up. With up to 19 months of follow-up only 1 patient had an adverse event [heart failure requiring admission] and increasing angina [treated with EECP].
Conclusions: Microvascular angina is effectively treated with EECP. There is a reduction in angina and provokable ischemia. The effect is durable with a low incidence of recurrent angina one year post treatment and few adverse cardiovascular events.