X-Message-Number: 10114
Date: Sat, 25 Jul 1998 09:02:57 -0700 (PDT)
From: Doug Skrecky <>
Subject: could external counterpulsation extend life span?

  External counterpulsation is a novel treatment for patients suffering
from cardiovascular disease. It consists of balloons placed on the legs
being contracted in phase with the pumping of the heart. It has no side
effects. It also increases exercise tolerance, and may decrease the risk
of a fatal heart attack.
  Question: Could external counterpulsation in healthy humans increase
their exercise tolerance and possibly increase human life span?

 Citations: 1-5

<1>
Authors
  Lawson WE.  Hui JC.  Zheng ZS.  Burgen L.  Jiang L.  Lillis O.  Oster Z. 
  Soroff H.  Cohn P.
Institution
  Department of Medicine, SUNY Health Sciences Center, Stony Brook 11794-8171,
  USA.
Title
  Improved exercise tolerance following enhanced external
  counterpulsation: cardiac or peripheral effect?.
Source
  Cardiology.  87(4):271-5, 1996 Jul-Aug.
Abstract
  The effect of treatment with enhanced external
  counterpulsation (EECP) on exercise hemodynamics and
  myocardial stress perfusion in 27 patients with chronic stable angina was
  studied. A majority (22/27 or 81%) of patients improved their exercise
  tolerance after EECP treatment, and a similar percentage (21/27 or 78%) of
  patients improved their radionuclide stress perfusion images. Post-EECP
  maximal exercise heart rate and blood pressure, while demonstrating a linear
  relation with exercise duration, did not increase significantly despite the
  increased exercise duration. This suggests that the increase in exercise
  duration after treatment with EECP is due to both improved myocardial
  perfusion and altered exercise hemodynamics. EECP therapy thus appears to
  exert a "training' effect, decreasing peripheral vascular resistance and the
  heart rate response to exercise. Coronary disease patients may improve their
  exercise tolerance after EECP because of both improved myocardial perfusion
  and a decrease in cardiac work load.

<2>
Authors
  Kasliwal RR.  Mittal S.  Kanojia A.  Bhatia ML.  Kronzon I.  Trehan N.
Institution
  Escorts Heart Institute, Okhla Road, New Delhi.
Title
  Sequential external counterpulsation: an adjunctive therapy
  for patients with chronic coronary artery disease and left ventricular
  dysfunction.
Source
  Indian Heart Journal.  48(2):150-4, 1996 Mar-Apr.
Abstract
  We assessed the clinical and haemodynamic improvement with 3 weeks of
  sequential external counterpulsation (SECP) therapy in 23
  patients with chronic coronary artery disease (CAD) and left ventricular (LV)
  dysfunction who were refractory to maximal tolerated doses of medical therapy
  and in whom intervention or surgery was not contemplated. All patients were
  subjected to one-hour duration of SECP for 3 weeks. SECP is a new noninvasive
  tool which increases coronary artery filling utilizing external pressure in a
  sequential manner from calf to thigh. A detailed clinical and
  echocardiographic evaluation was done before and after the completion of
  therapy to assess the utility of SECP. There were 18 males and 5 females with
  a mean age of 53 years. On coronary angiography, 39 percent patients had
  single, 8.7 percent had double and 48 percent had triple vessel disease. Four
  patients had coronary artery bypass graft (CABG) surgery in the past. Out of
  all patients, 48 percent had diffuse or distal coronary artery disease which
  was considered not suitable for CABG, 22 percent were not willing for
  intervention and 30 percent had other systemic diseases making them unfit for
  surgery. After 3 weeks of SECP, the anginal frequency reduced from 9
  episodes/week to 1 episode/week. Before SECP, 74 percent patients were in
  NYHA class III, whereas only 8.7 percent were class III symptomatic after
  SECP. All patients claimed symptomatic improvement of a mean of 6.8 +/- 1.4
  on a visual analog scale of 1-10. After SECP, the LV diastolic dimensions
  reduced from 54.6 +/- 7 to 51 +/- 7 mm, systolic dimensions reduced from 40
  +/- 8 to 36 +/- 8 mm and LVEF increased from 32.7 +/- 9 to 37.4 +/- 8.5
  percent. In conclusion, 3 weeks of therapy with SECP produces significant
  improvement in symptomatic status and cardiac function in patients with
  chronic CAD and LV dysfunction, refractory to medical therapy.

<3>
Authors
  Lawson WE.  Hui JC.  Zheng ZS.  Burger L.  Jiang L.  Lillis O.  Soroff HS. 
  Cohn PF.
Institution
  Department of Medicine, State University of New York at Stony Brook, USA.
Title
  Can angiographic findings predict which coronary patients will benefit from
  enhanced external counterpulsation?.
Source
  American Journal of Cardiology.  77(12):1107-9, 1996 May 15.
Abstract
  Enhanced external counterpulsation is an effective treatment
  for chronic angina. Theoretical considerations predict greatest benefit in
  patients with at least 1 patent conduit in this group of 50 patients (all of
  whom improved clinically). Improvement in radionuclide stress perfusion
  imaging was seen in 80% of treated patients and was inversely related to
  extent of coronary disease.

<4>
Authors
  Fricchione GL.  Jaghab K.  Lawson W.  Hui JC.  Jandorf L.  Zheng ZS.  Cohn
  PF.  Soroff H.
Institution
  Department of Psychiatry and Behavioral Science, SUNY at Stony Brook, USA.
Title
  Psychosocial effects of enhanced external counterpulsation
  in the angina patient.
Source
  Psychosomatics.  36(5):494-7, 1995 Sep-Oct.
Abstract
  Enhanced external counterpulsation (EECP) is a noninvasive
  pantaloon device designed to increase coronary artery flow in the treatment
  of angina. This pilot study, conducted in 1992-1993, which used psychosocial
  testing pre- and posttreatment, yielded data suggesting that EECP is well
  tolerated psychosocially and produces improvement in the anginal syndrome.
  More comprehensive research is under way to test these preliminary
  conclusions.

<5>
Authors
  Lawson WE.  Hui JC.  Zheng ZS.  Oster Z.  Katz JP.  Diggs P.  Burger L.  Cohn
  CD.  Soroff HS.  Cohn PF.
Institution
  Department of Cardiology, State University Health Sciences Center of New York
  (SUNY), Stony Brook 11794-8171, USA.
Title
  Three-year sustained benefit from enhanced external
  counterpulsation in chronic angina pectoris.
Source
  American Journal of Cardiology.  75(12):840-1, 1995 Apr 15.

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