Angina patients whose intense, often suffocating chest pains can not be reliably relieved by medication or invasive treatments can gain significant pain reduction from a little-used medical procedure that appears to increase heart blood supply, a new study has found.
In the first controlled trial of the painless, non-invasive treatment known as enhanced external counterpulsation (EECP), patients experienced less frequent angina pain and had less need for nitroglycerin to control pain than did a control group of angina patients.
The results are published in the June issue of the Journal of the American College of Cardiology.
Nationally, about 15 million people suffer from angina, more than two million chronically. The number is expected to increase as the population ages. And for almost all of these people, neither drugs nor vascular surgery provide complete relief.
"To find something that is very safe and effective in this group of patients is very gratifying," said Tony Chou, MD, assistant professor of medicine at UC San Francisco, a clinical cardiologist at UCSF Stanford Health Care and co-author of the report in the cardiology journal.
Patients undergoing the EECP treatment lie on a table and wear a series of cuffs on their legs. At the precise moment of every heartbeat when the heart relaxes, the cuffs briefly inflate. This is thought to reduce the heart's workload, increase its pumping efficiency and improve cardiac bloodflow. The treatment usually involves 35 one-hour sessions.
"The angina patients we treated with EECP have not found relief from any other treatment -- from medications, angioplasty or surgery. They are a very frustrated group of patients for whom we don't have anything to offer. This treatment functions almost like a very good medication," Chou said.
The technique, largely developed in China, has been tested clinically in various
forms over the past 30 years, with many reports of major success. But until now,
Contact: Wallace Raaven
University of California - San Francisco