EECP is an FDA-approved treatment for patients with coronary artery disease and unstable angina. EECP involves sequential inflation and deflation of compressible cuffs wrapped around the subject’s calves, lower thighs and upper thighs.
EECP is a non-invasive, outpatient therapy.
The EECP treatment gently but firmly compresses the blood vessels in the lower limbs to increase blood flow to your heart. Each wave of pressure is electronically timed to the heartbeat, so that the increased blood flow is delivered to your heart at the precise moment it is relaxing.
EECP Treatment
Non-invasive outpatient therapy
EECP treatment usually takes about one hour. Treatment is daily and may extend from five to twelve weeks or more. Patients are placed on a comfortable table and pneumatic stockings or cuffs are fitted to the calf and lower and upper thighs on each leg. These cuffs are hooked-up to a monitor which enables the physician to make adjustments to the pressure as necessary.
The cuffs are choreographed to inflate and deflate based on the results of an electrocardiogram (EKG), which measures heart rhythm. Because ECP increases the pressure on the blood flowing through the aorta while the heart is at rest, the heart receives extra oxygen enriched blood.
What Is EECP?
Enhanced External Counter Pulsation (EECP) is performed as a non-invasive treatment to lower the number and intensity of angina episodes. Treatment is administered through three pairs of external inflatable cuffs that are applied around the lower legs, upper legs and buttocks. These cuffs continuously inflate and deflate between the resting period of the heartbeat and increase blood returned to the heart.
The basic principle of EECP treatment involves increasing the amount of blood returning to the heart, which helps supply more oxygen to its starved areas. With more oxygen available, the heart can function much more efficiently and therefore reduce chest pain.
Who Is Eligible for EECP Treatment?
Individuals are eligible for treatment if they have:
– Had coronary artery bypass (CABG) or stents placed in the coronary arteries with ongoing angina.
– Had no prior bypass or stenting but continue to suffer from angina
Who Should Not Seek EECP Treatment?
Patients who should not undergo EECP include those with:
- Hypertrophic cardiomyopathy
Congenital heart disease
Valvular disease
Enlarged heart
Pacemaker
Hemorrhage
Atrial fibrillation (Afib)
Pulmonary hypertension
Clot in their body
Peripheral artery disease (PAD), also called peripheral vascular disease (PVD)
Severe elevated blood pressure
Heart rate greater than 120 beats per minute
What Are the Benefits of EECP Treatment?
Increased oxygen supply for the heart
Decrease in chest pain
Improved EKG response to exercise
Decrease in nitroglycerin use
Increase in energy
Increased exercise duration
Long term effects up to 2 years
Diabetes is a condition where the glucose in your blood is higher than average. This condition is due to your pancreas not able to secrete enough insulin to help the body cells utilize the blood glucose, or your cells become resistant to the insulin.
There are many strategies followed to manage diabetes. The most simple one is exercise, which is remarkably comparable with the most complex approach of the administration of drugs. Exercise can able to increase insulin secretion and also able to reduce insulin resistance. EECP treatment has shown to act as an intensive exercise, so its effect will undoubtedly have a favorable impact on blood glucose levels in diabetic patients.
EECP Reduces Blood Sugar Levels.
Studies have shown a course of EECP in patients with Type II diabetes mellitus has shown to decrease blood glucose levels and glycosylated hemoglobin levels significantly. The treatment will help the patients to have excellent control over their blood glucose levels with ease. The procedure is also risk-free and can also be repeated when needed. So, EECP for diabetes control will be a new non-drug, natural strategy.
The long term complication of diabetes is vascular damage, both microvascular and macrovascular. This damage is due to the chronically elevated blood glucose level. Uncontrolled diabetes leads to impaired nitric oxide production by the vascular endothelium, which is basically the cells lining and providing cover to the inner part of vessels.
EECP Protect Blood Vessels.
Nitric oxide is a potent natural vessel wall protector against stress, inflammation, prevents thrombus ( clot ) formation, and helps the vessel to retain its flexibility or dilatory property. EECP treatment has shown this nitric oxide level up to 51.9%. This increased level of nitric oxide will have protection against micro and macro vessel complication in diabetes patients.
Another important mechanism of blood glucose control by the body is the ability of insulin to regulate the uptake of glucose utilization by skeletal muscle, cardiac muscle, brain, and adipose tissue. This utilization is mediated by a transport transporter protein called GLUT 4.
The primary usage of glucose is our skeletal muscles. A study has shown a course of EECP treatment has increased the skeletal muscle GLUT-4 protein by 47%. Now, this increase in nitric oxide and GLUT-4 protein together plays a major role in the uptake of glucose and enhancing the insulin effect. Overall, the insulin sensitivity index ( ISI) improved by 21%. It means post EECP treatment; patients only require less level of insulin to reduce the blood glucose level.
The net benefit is patients fasting blood sugar level decreases up to 17 mg/dl, and similarly, postprandial 120 min blood sugar decreases up to 28mg/dl. The measure of the average blood sugar level over 2-3 months HBAIC ( Glycated hemoglobin test) also reduced significantly. These studies show EECP for diabetes patients can enhance better utilization of blood sugar levels.
The Word cholesterol immediately rings a bell linking it to heart disease and stroke. Cholesterol or lipid profile consists of four major components, 1.Total Cholesterol, 2.Triglyceride, 3.Low-density lipoprotein cholesterol (LDL-C), and 4.High-density lipoprotein cholesterol (HDL-C).
Other components of lipid profile like, Very Low -density lipoprotein cholesterol (VLDL-C), and Non-High-density lipoprotein cholesterol (Non-HDL-C) are derived from the above four major components.
Having high cholesterol in the younger age group with unhealthy food habits coupled with a sedentary lifestyle and obesity increases the risk of heart disease significantly higher at a younger age. To reduce the high cholesterol level, an individual has to engage in regular moderate aerobic exercise, maintain a healthy body mass index, and control the intake of high saturated fatty acid in the diet.
The mechanism of how exercise reduces the cholesterol level is still not precisely understood. The optimal physical activity or the exercise intensity and duration we should achieve to have a significant reduction in lipid levels is still not well established.
EECP Reduces Bad And Increases Good Cholesterol.
Nevertheless, the introduction of statin ( Lipid-lowering drug ) has now been given in a very early part of age as a replacement for exercise, or general assumption; we may not be able to achieve the recommended exercise capacity. Many trials have pointed out Aerobic exercise has a significant effect on the triglyceride level. Still, the same cannot be said for other lipid components, Total cholesterol, LDL, and HDL level.
However, statin drugs have a clear advantage of reducing LDL levels amount to the level of 29-53%. But this comes with the expense of adverse effects of statin drugs. It includes muscle pain and damage, elevated liver enzymes due to inflammatory damage to liver cells, increase your chance of getting diabetes and memory loss.
EECP can change this perception as it can provide a passive exercise and stimulate the effect of intense aerobic exercise. This effect has already shown to amplify your exercise effect and have a profound favorable impact on your lipid profile. Studies have shown EECP significantly reduces cholesterol, triglyceride, and LDL around 20-30% and improves good HDL cholesterol by around 15%.
Blood pressure is due to the contraction of cardiac muscle to push the blood into the large arteries. When the heart contracts and push the blood outside its chambers, the pressure rise within the large arteries, and this maximum raise recorded is called the systolic pressure. When the heart relaxes, the pressure in the large arteries falls, and the lowest pressure recorded is called the diastolic pressure.
However, the interpretation of systolic and diastolic pressure is not this simple as its portrait. It’s not only the cardiac muscle contraction, but also the resistance offered by the large vessel also determines the blood pressure.
EECP Training Effect.
EECP treatment in the wellness program helps toimprove the blood flow in the reverse direction in the arterial end during the heart relaxation period ( diastole ). It is where the blood pressure falls, and the recorded pressure is called diastolic pressure. So the vessels are exposed to increase blood flow during the heart contraction phase ( systolic pressure ) and heart relaxation phase.
This twofold increase in blood flow has a profound effect on the arterial vessel wall. It stimulates the cells lining the vessel wall to secrete nitric oxide and reverse the arterial stiffness or resistance. It leads to a reduction in blood pressure naturally without drugs. This alteration of arterial stiffness resulting drop in blood pressure is called the “EECP training effect.”
EECP For Hypertension.
The decrease in systolic blood pressure ranges from 6 mmHg to a maximum of 35 mmHg based on the baseline pressure. Patients with hypertension with higher baseline blood pressure had more drop in blood pressure when compared to patients with normal or mildly elevated blood pressure. The decrease in blood pressure reflects vascular health is improved after a course of EECP treatment.