University of Virginia Health System

U.VA. HAS TECHNOLOGY TO PERFORM NON-INVASIVE HEART PROCEDURE

According to new research presented this week at the American Heart Association's Scientific Sessions 2001 conference, enhanced external counterpulsation therapy (EECP) promotes the release of chemicals that trigger new blood vessel growth, thereby reducing chest pain. This research shows promise for EECP as an alternative for procedures such as angioplasty or bypass surgery to treat patients not suitable for these procedures, and who have incapacitating angina despite optimal medical therapy. The University of Virginia Health System is one of four hospitals in the state equipped to perform EECP treatment.

As a noninvasive and outpatient therapy, EECP therapy appears to increase circulation in areas of the heart with less than adequate blood supply. The treatment appears to stimulate the opening of new, natural pathways around narrowed or blocked arteries. The system uses pneumatic cuffs, similar to cuffs used to measure blood pressure, that sequentially compress the lower limbs to increase blood flow toward the heart. Each wave of pressure is electronically timed to the patient's heartbeat, so that the increased blood flow is delivered to the heart at the precise moment it is relaxing. It is during relaxation of the heart muscle that blood flows down the coronary arteries. This strategy also lowers resistance in the blood vessels of the legs so that blood may be pumped more easily from the heart, decreasing the amount of work required of the heart muscle. Timing of the inflation and deflation of the cuffs is regulated by running electrocardiogram signals through a microcompressor that monitors the treatment.

EECP therapy clearly provides symptomatic improvement in these patients with underperfused, but viable heart muscle, said Dr. Ian Sarembock, director of the Coronary Care Unit at U.Va. The vast majority of patients have much less angina and are able to restart an exercise program, and this benefit is maintained in many patients well beyond the treatment phase, often for many months.

In addition, patients are strongly encouraged to get nutrition consultation and enter a rehabilitation program. To date, U.Va. has enrolled 50 patients over the last two-and-a-half years, according to Sarembock. U.Va. also is involved in a research study to better understand the mechanisms by which the therapy works.

Vasomedical, the company that supplies the hospitals with the EECP equipment and training, is engaged in research to determine potential benefits of EECP therapy in the management of other major vascular disease states, including congestive heart failure and diabetes.

November 19, 2001