Enhanced External Counterpulsation (EECP) dan Arah Masa Depan
Abstract
Diperkirakan 6,4 juta pasien di USA menderita penyakit jantung koroner (PJK) simptomatik (Coronary Artery Disease/CAD), dan sekitar 400.000 kasus baru muncul tiap tahunnya. Meskipun telah diIakukan terapi medis optimal dan prosedur invasif seperti angioplasti dan bedah pintas koroner (coronary artery bypass graft/CABG), diperkirakan terdapat 300.000 – 900.000 pasien menderita angina pektoris refrakter (RAP). Sekitar 25.000 - 75.000 kasus baru RAP terdiagnosa tiap tahunnya.Saat ini ada beberapa terapi alternatif non farmakologis bagi pasien RAP dengan atau tanpa gagal jantung, yaitu : neurostimulasi (rangsangan listrik syaraf transkutaneus dan stimulasi medula spinalis), EECP (Enhanced External Counterpulsation), teknik revaskularisasi laser, terapi gen, dan prosedur intervensi terbaru seperti perkutaneus in situ koronari venous arterialisasi atau perkutaneus in situ coronary artery bypass. Dari modalitas- modalitas terapi tersebut, EECP mewakili teknik yang benar-benar non-invasif. EECP dapat mengurangi gejala angina dan area iskemik miokard secara obyektif, serta memperbaiki fungsi sistolik maupun diastolik ventrikel kiri. Makalah ini akan meringkas bukti-bukti yang ada saat ini tentang penggunaan terapi EECP pada angina stabil dan gagal jantung. Juga dibicarakan arah pemakaian EECP di masa mendatang.
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References
Akhtar M, Wu GF, Du ZM, Zheng ZS, Michaels AD. Effect of external counter- pulsation on plasma nitric oxide and endothelin-1 level. Am J Cardiol 2006;98:28-30.
Arora R, Chen HJ, Rabbani L. Effects of enhanced counterpulsation on vascular cell release of coagulation factors. Heart Lung 2005;34:252-6.
Arora RR, Chou TM, Jain D, et aI. The Multicenter Study of Enhanced External Counterpulsation (MUST-EECP): efect of EECP on exercise-induced myocardial ischemia and anginal episodes. .J Am Coll Cardiol 1999;33:1833-40.
Arora RR, Chou TM, Jain D. et al. Effects of enhanced external counterpulsation on health-related quality of life continue 12 months after treatment: a substudy of the multicenter study of enhanced external counterpulsation. J Investig Med. 2002;50:25-32.
Bonetti PO, Baraness GW, Keelan PC, et aI. Enhanced external counterpulsation improves endothelial function In patients with symp tomatic coronary artery disease. J Am Coll Cardiol 2003;41:1761-8.
Chen XL, He XH, Zhang Y, et al. (Effect of chronic enhanced external counterpulsation on arterial endothelial cells of porcine with hypercholesteromia). Di Yi Jun Yi Da Xue Xue Bao 2005;25:1491-3.
Cohen, Grossman W, Michaels AD. Portable enhanced external counterpulsation for acute coronary syndrome and cardiogenic shock: a pilot study. Clin Cardiol 2007;30:223-8.
Fitzgerald CP, J Lawson WE, Hui JC, Kennard ED, IEPR investigator. Enhanced external counterpulsation as initial revascularization treatment for angina refractory to medical therapy. Cardiology 2003;100:129-35.
Garlichs CD, Zhang H, Werner D, John A, Trigner P, Daniel WO. Reduction of serum endothelin-1 levels by pneumatic external counterpulsation (abatr). Can J Cardiol1998;14 Suppl:87F.
Kim MC, Kini A, Sharma SK. Refractory angina pectoris: mechanism and therapeutic options. J Am Coll Cardiol 2002;39:923-34.
Lawson WE, Hui JC, Zheng ZS, et al. Improved exercise tolerance following enhanced external counterpuIsation: cardiac or peripheral efect? Cardiology. 1996;87:271-5.
Lawson WE, Hui JCK, Cohn PF. Long-term prognolisis of patients with angina treated with enhanced external counterpulsation: five-year follow-up study. Clin Cardiol 2000;23:254-8.
Lawson WE, Hui JCK, Guo T, Burger L, Cohn PF. Prior revascu larization increases the effectiveness of enhanced external counterpul sation. Clin CardioI 1998:21:841-4.
Lawson WE, Hui JCK, Soroff HS, et al. Efficacy of enhanced external counterpusation? Am J Cardiol 1992;70:859-62.
Lawson WE, Hui JCK, Zheng ZR, et al. Improved exercise tolerance following enhanced external counterpulsation: cardiac or peripheral effect? Cardiology 1996:87:271-5.
Lawson WE, Hui JCK, Zheng ZS, et al. Can angiographic findings predict which coronary patients will benefit from enhanced external counterpulsation? Am J Cardiol 1996; 77:1107-9.
Lawson WE, Silver MA, Hui JC, Kennard ED, Kelsey SF. Angina patients with diastolic versus systolic heart failure demonstrate comparable immediate and one-year benefit from enhanced external counterpulsation. J Card Fail 2005;11:61-6.
Lawson WF., Hui JCK, Lang G. Treatment benefit in the enhanced external counterpulsation consortium. Cardiology 2000;94:31-5.
Levenson J, Pernollet MG, Illiou MC, Devynck MA, Simon A. Cyclic GMP release by acute enhanced external counterpulsation. Am J Hypertens 2006;19:867-72.
Machanda A, Soran D. Exhanced external counterpulsation and future direction. J Am Coll Cardiol 2007;16;1523-1531.
Masuda D, Nohara R, Hirai T, et al. Enhanced external counterpul-sation improved myocardial perfusion and coronnry flow reserve in patients with chronic stable angina. Eur Heart J 2001;22:1451-8.
Masuda D, Nohara R, lnada H, et al. Improvement of regional myocardial and coronary blood flow reserve in a patient treated with enhanced external counterpulsation: evaluation by nitrogen-13 ammo nia PET. Jpn Circ J 1999;63:407-11.
Ochon AB, Dejong A, Grayson D, Franklin B, McCullough P. Effect of enhanced external counterpulsation on resting oxygen uptake in patients having previous coronary revascularization and in healthy volunteers. Am J Cardiol 2006;98:613-5.
Stys TP, Lawson WE. J Hui JCK. et al. Effects of enhanced external counterpulsation on stress radionuclide coronnry perfusion and exercise capacity in chronic stable angina pectoris. Am J Cardiol 2002:89:822-82.
Tao J, Tu C, Yang Z, Zhang Y, Chung XL. Enhanced external counterpulsation improve endothdium-dependent vasorelaxation in the carotid arteries of hypercholesterolemic pigs. Int J Cardiol 2006;112:269..74.
Tseng H, Peterson TE, Berk BC. Fluid shear stress stimulates mitogen-activated protein kinase in endothelial cells. Circ Res 1995;77:869-78.
Urano H, Ikeda H. Enhanced external counter pulsation improves exercise tolerance, reduces exercise-induced myocardial ischemia and improves left ventricular diastolic filling in patients with coronary artery disease. J Am Coll Cardiol 2001;37:93-9.
Zhang Y, Chen XL, He XH, et al. Effcets of enhanced external counterpulriation In atherosclerosls and NF-kappaB expression: II pig model with hypercholesterolemia. Zhonghua Bing Li Xue Za Zhi 2006:35:159-64.
Zheng ZS, Li TM, Kambic H, et al. Sequential external counterpul sation (SECP) in China. Trans Am Soc Artif Intern Organs. 1983; 29:599-603.
Arora R, Chen HJ, Rabbani L. Effects of enhanced counterpulsation on vascular cell release of coagulation factors. Heart Lung 2005;34:252-6.
Arora RR, Chou TM, Jain D, et aI. The Multicenter Study of Enhanced External Counterpulsation (MUST-EECP): efect of EECP on exercise-induced myocardial ischemia and anginal episodes. .J Am Coll Cardiol 1999;33:1833-40.
Arora RR, Chou TM, Jain D. et al. Effects of enhanced external counterpulsation on health-related quality of life continue 12 months after treatment: a substudy of the multicenter study of enhanced external counterpulsation. J Investig Med. 2002;50:25-32.
Bonetti PO, Baraness GW, Keelan PC, et aI. Enhanced external counterpulsation improves endothelial function In patients with symp tomatic coronary artery disease. J Am Coll Cardiol 2003;41:1761-8.
Chen XL, He XH, Zhang Y, et al. (Effect of chronic enhanced external counterpulsation on arterial endothelial cells of porcine with hypercholesteromia). Di Yi Jun Yi Da Xue Xue Bao 2005;25:1491-3.
Cohen, Grossman W, Michaels AD. Portable enhanced external counterpulsation for acute coronary syndrome and cardiogenic shock: a pilot study. Clin Cardiol 2007;30:223-8.
Fitzgerald CP, J Lawson WE, Hui JC, Kennard ED, IEPR investigator. Enhanced external counterpulsation as initial revascularization treatment for angina refractory to medical therapy. Cardiology 2003;100:129-35.
Garlichs CD, Zhang H, Werner D, John A, Trigner P, Daniel WO. Reduction of serum endothelin-1 levels by pneumatic external counterpulsation (abatr). Can J Cardiol1998;14 Suppl:87F.
Kim MC, Kini A, Sharma SK. Refractory angina pectoris: mechanism and therapeutic options. J Am Coll Cardiol 2002;39:923-34.
Lawson WE, Hui JC, Zheng ZS, et al. Improved exercise tolerance following enhanced external counterpuIsation: cardiac or peripheral efect? Cardiology. 1996;87:271-5.
Lawson WE, Hui JCK, Cohn PF. Long-term prognolisis of patients with angina treated with enhanced external counterpulsation: five-year follow-up study. Clin Cardiol 2000;23:254-8.
Lawson WE, Hui JCK, Guo T, Burger L, Cohn PF. Prior revascu larization increases the effectiveness of enhanced external counterpul sation. Clin CardioI 1998:21:841-4.
Lawson WE, Hui JCK, Soroff HS, et al. Efficacy of enhanced external counterpusation? Am J Cardiol 1992;70:859-62.
Lawson WE, Hui JCK, Zheng ZR, et al. Improved exercise tolerance following enhanced external counterpulsation: cardiac or peripheral effect? Cardiology 1996:87:271-5.
Lawson WE, Hui JCK, Zheng ZS, et al. Can angiographic findings predict which coronary patients will benefit from enhanced external counterpulsation? Am J Cardiol 1996; 77:1107-9.
Lawson WE, Silver MA, Hui JC, Kennard ED, Kelsey SF. Angina patients with diastolic versus systolic heart failure demonstrate comparable immediate and one-year benefit from enhanced external counterpulsation. J Card Fail 2005;11:61-6.
Lawson WF., Hui JCK, Lang G. Treatment benefit in the enhanced external counterpulsation consortium. Cardiology 2000;94:31-5.
Levenson J, Pernollet MG, Illiou MC, Devynck MA, Simon A. Cyclic GMP release by acute enhanced external counterpulsation. Am J Hypertens 2006;19:867-72.
Machanda A, Soran D. Exhanced external counterpulsation and future direction. J Am Coll Cardiol 2007;16;1523-1531.
Masuda D, Nohara R, Hirai T, et al. Enhanced external counterpul-sation improved myocardial perfusion and coronnry flow reserve in patients with chronic stable angina. Eur Heart J 2001;22:1451-8.
Masuda D, Nohara R, lnada H, et al. Improvement of regional myocardial and coronary blood flow reserve in a patient treated with enhanced external counterpulsation: evaluation by nitrogen-13 ammo nia PET. Jpn Circ J 1999;63:407-11.
Ochon AB, Dejong A, Grayson D, Franklin B, McCullough P. Effect of enhanced external counterpulsation on resting oxygen uptake in patients having previous coronary revascularization and in healthy volunteers. Am J Cardiol 2006;98:613-5.
Stys TP, Lawson WE. J Hui JCK. et al. Effects of enhanced external counterpulsation on stress radionuclide coronnry perfusion and exercise capacity in chronic stable angina pectoris. Am J Cardiol 2002:89:822-82.
Tao J, Tu C, Yang Z, Zhang Y, Chung XL. Enhanced external counterpulsation improve endothdium-dependent vasorelaxation in the carotid arteries of hypercholesterolemic pigs. Int J Cardiol 2006;112:269..74.
Tseng H, Peterson TE, Berk BC. Fluid shear stress stimulates mitogen-activated protein kinase in endothelial cells. Circ Res 1995;77:869-78.
Urano H, Ikeda H. Enhanced external counter pulsation improves exercise tolerance, reduces exercise-induced myocardial ischemia and improves left ventricular diastolic filling in patients with coronary artery disease. J Am Coll Cardiol 2001;37:93-9.
Zhang Y, Chen XL, He XH, et al. Effcets of enhanced external counterpulriation In atherosclerosls and NF-kappaB expression: II pig model with hypercholesterolemia. Zhonghua Bing Li Xue Za Zhi 2006:35:159-64.
Zheng ZS, Li TM, Kambic H, et al. Sequential external counterpul sation (SECP) in China. Trans Am Soc Artif Intern Organs. 1983; 29:599-603.
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How to Cite
Sargowo, D. (1). Enhanced External Counterpulsation (EECP) dan Arah Masa Depan. Indonesian Journal of Cardiology, 29(1), 47-55. https://doi.org/10.30701/ijc.v29i1.202
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