ISSN: 1306-7656
Dil: Türkçe, İngizlizce
İçerik: Orjinal araştırma, Derleme, editöryel yorum, editöre mektup, tıbbi eğitim, bilimsel mektup, cerrahi teknik, tıbbi kitap değerlendirmeleri, orjinal görüntüler, soru cevaplar, ayrıcı tanı
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Enhanced External Counterpulsation (eecp): Review
Dr. Soner YAVAŞa
aKalp ve Damar Cerrahisi Kliniği, Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi, ANKARA
Heart failure and angina pectoris remain a significant health problem in the world. Although there are a variety of pharmacologic and interventional therapies to treat angina and heart failure, some patients are not adequately helped by these treatments and side effects of medications, diminishing treatment benefit or coronary vasculature not amenable to revascularization may occur over time.
The need for new therapies has yielded an effective and well tolerated noninvasive technique for the treatment of these patients: Enhanced External Counterpulsation (EECP).
In simplest terms, EECP involves squential inflation and deflation of compressive cuffs wrapped around the patient’s calves and thigts. During diastole cuffs inflate sequentially to raise diastolic aortic pressure and venous return and during the onset of systole rapidly deflate to unload left ventricle. The combination of these events results in an increase of coronary perfusion and cardiac output, a decrease of myocardial oxygen demand, and facilitates the development of coronary collaterals as has been reported with the use of intraaortic balloon counterpulsation. EECP reduces angina and extends time to exercise-induced ischemia in patients with angina refractory to medical and interventional therapies. In addition to its acute hemodynamic effects, EECP also produces neurohormonal and cardiac changes which persist after treatment.
Because of variations in treatment protocol and variable clinical results, further studies are needed to determine its appropriate clinical application.Keywords: Counterpulsation; heart failure, congestive; coronary arteriosclerosis; angina pectorisTurkiye Klinikleri J Cardiovasc Sci 2007, 19:165-173
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