Since the early 1970’s the first successful clinical studies by Professor Zeng Zhengsheng from China demonstrated external counterpulsation (ECP) increased survival rates of patients during heart attacks and cardiogenic shock, as well as relieved angina pains. By 1990, 1800 ECP centres were operating successfully in China.
Open label studies on the safety and effectiveness of ECP in patients with chronic stable angina pectoris were conducted at the state University of New York at Stony Brook, beginning in 1989 and were reported by Lawson et al in American Journal of Cardiology in 1992. All of these patients had incapacitating symptoms, refractory to medical therapy and exertional myocardial ischaemia documented by thallium-
All patients in this study showed a substantial improvement in symptoms with most reporting a complete absence of angina during normal activity. In addition, the majority of the patients in this study showed a reduction in myocardial ischaemia, with two-
A large study in China of more than six thousand patients found an improvement of 90% of the participants. A long term cohort study found that 74% of ECP patients maintained improvements in angina symptoms seven years after completion of ECP therapy. These patients were four times less likely to suffer a cardiac death in eight years after receiving ECP treatments than cardiac patients treated with medication alone.1 The Bypass Angioplasty Revascularisation Investigation (BARI study) is the largest randomised clinical trial to compare bypass surgery and angioplasty. This study showed that 21% of bypass patients and 22% of angioplasty patients either died or suffered from heart attacks during the first five years after surgery. In addition, 8% of bypass patients and 54% of angioplasty patients had to undergo repeat surgery or other invasive procedures within the next five years.2 Subsequent studies taking 323 patients who were still symptomatic after medication, and undergoing invasive and surgical procedures, were treated with ECP. These patients were compared to 448 patients earlier in the progression of disease who underwent non-
1. Y.y Xu,D.Y.Hu,Z.S. Zheng, 1990. “External Counterpulsation –
2. The Bypass Angioplasty Revascularisation Investigation (BARI) Investigation, 1996. “Comparison of Coronary Bypass Surgery with Angioplasty in Patients with Multivessel Disease.” The New England Journal of Medicine335:217-
3. Holubkov R, Kennard E.D, Foris J.M, et al. 2002. “Comparison of Patients Undergoing Enhanced External Counterpulsation and Percutaneous Coronary Intervention for Stable Angina Pectoris,” The American Journal of Cardiology89:1182-
4. J. Tartaglia, J. Stenerson Jr., R. Charney, et al., 2003. “Exercise Capability and Myocardial Perfusion in Chronic Angina Patients with Enhanced External Counterpulsation,” Clinical Cardiology 26 : 287 –
5. Arora RR, Chou TM, Jain D, Fleishman B, Crawford L, McKiernan T, Nesto R. 1999.
The Multicenter Study of Enhanced External Counterpulsation (MUST-