ABSTRACT
The aim of this study was to echocardiographically assess the effects of EECP [Enhanced External Counterpulsation Therapy] therapy on systolic and diastolic cardiac function. LVEF [left ventricular ejection fraction], ESV [end-systolic volume], EDV [end-diastolic volume], Sm [myocardial systolic wave], Ea [myocardial early diastolic wave], Vp [propagation velocity], E/Ea [peak early diastolic transmitral flow velocity/Ea], E/Vp and diastolic function grade were studied in twenty-five patients before and after 35 hours of EECP. EECP reduced ESV and EDV and increased EF significantly [p=0.018, 0.013, 0.002, respectively] in patients with baseline LVEF 50%. Patients with E/Ea >/= 14 had a significant reduction in EDV and ESV [p=0.038 and 0.32, respectively] and an increase in LVEF [p=0.007] after EECP, whereas patients with baseline E/Ea<14 had no significant change in these parameters. Similarly, EECP significantly improved ESV, EDV and LVEF [p=0.014, 0.032, 0.027 respectively] in patients with grades II and III of diastolic dysfunction [decreased compliance] at baseline, but not in patients with normal diastolic function or grade I diastolic dysfunction [impaired relaxation]. Patients with Ea<7 cm/sec prior to EECP showed significant improvement in EDV, ESV and LVEF after therapy [p=0.024, 0.015, 0.001], while patients with Ea >/= 7cm/sec showed no significant change. Similarly, patients with Sm<7cm/sec prior to EECP showed significant improvement in EDV, ESV and LVEF after EECP [p=0.016, 0.017, 0.006], while patients with Sm >/= 7 cm/sec did not. These results provide new insight into the hemodynamic effectiveness and potential clinical applications of EECP