Effectiveness of enhanced external counter pulsation on clinical profile and health-related quality of life in patients with coronary heart disease: a systematic review

Abstract

Introduction. Enhanced External Counter Pulsation (EECP) is a non-invasive United States Food and Drug Administration (FDA) approved outpatient treatment option for the complex problem of angina, a common symptom of coronary heart disease. A systematic review of the literature searched to assess the effect of EECP on the clinical profile that comprised physiological measurements, biochemical assessments, cardiac clinical symptoms, physical functional status, and Health-Related Quality of Life (HRQoL) in Coronary Heart Disease (CHD) patients. Material and methods. Total 258 EECP research articles from the early stage of EECP development to till date screened. Out of 258 EECP articles, total 60 articles (53 EECP articles for clinical profile and 7 article for HRQoL matched the inclusion criteria and other (n = 198) articles excluded due to irrelevant to study objectives. Results. All enrolled studies showed a significant improvement in angina pectoris and HRQoL with reduction of nitroglycerine use and exercise tolerance. There are several gaps in research has been found for further research to evaluate the EECP effectiveness on Body Mass Index (BMI), Heart Rate, Cholesterol, Triglyceride, High Density Lipoprotein (HDL), Low Density Lipoprotein (LDL), HbA1C, SpO2, Vo2max level with a comparative assessment of cardiac and non-cardiac metabolic markers including blood glucose. Conclusions. There is further need of multi-centric randomize controlled trial studies to evaluate the effect of EECP on obese, diabetic, hypertension and other metabolic disease patients and more research required for further modifications in EECP device to cure, prevent and treat chronic diseases by the non-invasive procedure.