Working Principles and Mechanism of Benefit of EECP

Abstract

Enhanced External Counter pulsation therapy involves of a bed connected to an air compressor which is connected to a computerized control. Also, there are 3 sets of cuffs covered the patient’s lower legs and patients’ buttocks. It is controlled by electrocardiography, which liberates a hemodynamic activity same of an intra-aortic balloon pump. The EECP-therapy is designed to raise the venous return, by this mechanism the EECP- therapy differs from intra-aortic balloon pump (IABP) therapy. EECP-Therapy produces high external pressure which reaches to 300 mmHg. The course of EECP-therapy composed of 35 treatments as one hour every day for seven weeks. The EECP-therapy raises venous return, increases cardiac preload, raises cardiac output and reduces the vascular resistance. The EECP-Therapy had a beneficial effect on endothelial-derived vasoactive agents and also had anti-inflammatory activities may decrease the future risk of cardiovascular disorders. Following EECP-therapy, plasma NOx level increased, nitric oxide has antioxidative properties could suppress oxidative stress. The simplest mechanism by which EECP might increase collateral perfusion is by opening preformed collateral channels, either directly via increasing diastolic blood pressure and flow or indirectly via release of vasodilatory mediators such as NO. Angiogenesis, the de novo formation of capillary blood vessels via sprouting of endothelial cells from existing blood vessels, may also be promoted by EECP therapy.