1 / 14

History and Clinical Development of EECP

Anthony N. DeMaria MD, MACC Judith and Jack White Chair in Cardiology, Professor of Medicine, Chief, Cardiovascular Medicine. University of California at San Diego San Diego, California Member, Scientific Council (Vasomedical). History and Clinical Development of EECP.

irma
Download Presentation

History and Clinical Development of EECP

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Anthony N. DeMaria MD, MACCJudith and Jack White Chair in Cardiology, Professor of Medicine, Chief, Cardiovascular Medicine.University of California at San Diego San Diego, CaliforniaMember, Scientific Council (Vasomedical) History and Clinical Development of EECP

  2. History of External Counterpulsation

  3. Evolution of Counterpulsation Birtwell’s Arterial Counterpulsator Intra-Aortic Balloon Pump External Counterpulsation

  4. Single-chamber hydraulic counterpulsation –Circa 1968

  5. Increased Coronary Artery Perfusion 120 C D F mm Hg 100 B B 80 E A Reduced Myocardial O2 Demand Counterpulsation Timing A = One complete cardiac cycle B = Unassisted aortic end-diastolic pressure C = Unassisted systolic pressure D = Diastolic Augmentation E = Reduced aortic end-diastolic pressure F = Reduced systolic pressure

  6. Intracoronary Pressure with EECP Michaels et al; Circ. 106, 2002

  7. EECP: Effect on Exercise* (MUST-EECP) p > 0.3 p = 0.01 Time (Seconds) Exercise Duration Time to ST Depression * Adjusted mean of change from baseline Arora RR, et al. J ACC 1999;33

  8. MUST-EECP: DailyAngina Counts Active (N=57) Sham(N=59) Active (N=71) Sham (N=66) Per Protocol ( ≥ 35 hours ) } P < 0.02 Intention-to-treat (all patients) } P < 0.05 % Change MUST-EECP Arora RR, et al. J Am Coll Cardiol 1999;33:1833-40

  9. HQOL Changes Using SF36 and QL Index Instruments (Baseline to 1 Yr Follow-up) Physical Functioning (Work) Role Disability Due to Physical Health Bodily Pain General Health Vitality St. Sig. Within Group Difference St. Sig. Between Group Difference Social Functioning (Work) Role Disability Due to Emotional Health Mental Health Cardiac Specific Health & Functioning Magnitude of Improvement or Decline Expressed in Standard Deviation Units

  10. INTERNATIONAL EECP PATIENT REGISTRY Phase I 92 Centers • 82 in United States • 5 in Europe • 5 Other international 5222 patients enrolled 5718 courses of EECP therapy Data on File: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh

  11. Change in Angina Class with EECP: IEPR Michaels et al; AJC. 2004

  12. Symptomatic Coronary Artery DiseasePopulation need and suitability Medication Needing intervention Inoperable or high risk

  13. EECP Symposium Patient selection Results of clinical trial-work Future indications Heart Failure Possible mechanisms First-hand clinical experience

  14. End of Anthony N. DeMaria, MD, MACCPresentation

More Related