Clinical Evidence

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Since 1992, there have been more than 150 papers published in peer reviewed medical journals demonstrating EECP® Therapy as a non-invasive, safe, low-cost and highly effective treatment for patients with coronary artery disease. There are 8 randomized controlled trials (RCT) documenting the clinical outcomes and mechanisms of action of EECP® Therapy. The most well-known RCTs were the Multicenter Study of EECP® (MUST-EECP® ) in the treatment of patients with angina pectoris and Prospective Evaluation of EECP® in Congestive Heart Failure (PEECH™ trial for heart failure patients age 65 or older. For a complete Bibliography or Synopsis of the Clinical Studies for EECP® Therapy, please visit:


Case Studies

Enhanced external counterpulsation: an innovative physical therapy for refractory angina.
Braverman DL.
PM R. 2009 Mar;1(3):268-76. Review.
PMID: 19627906 [PubMed – indexed for MEDLINE]

Effect of enhanced external counterpulsation on clinical symptoms, quality of life, 6-minute walking distance, and echocardiographic measurements of left ventricular systolic and diastolic function after 35 days of treatment and at 1-year follow up in 47 patients with chronic refractory angina pectoris.
Kumar A, Aronow WS, Vadnerkar A, Sidhu P, Mittal S, Kasliwal RR, Trehan N.

Treatment options for refractory angina pectoris: enhanced external counterpulsation therapy.
Soran O.Am J Ther. 2009 Mar-Apr;16(2):116-8.PMID: 19300038 [PubMed – indexed for MEDLINE]

A new treatment modality in management of patients with cardiac syndrome X: Enhanced external counterpulsation.
Celik T, Iyisoy A, Yuksel UC, Amasyali B.
Curr Treat Options Cardiovasc Med. 2009 Feb;11(1):54-60.PMID: 19141261 [PubMed – in process]
Int J Cardiol. 2008 Dec 29. [Epub ahead of print]PMID: 19117626 [PubMed – as supplied by publisher]

Enhanced external counter pulsation and future directions: step beyond medical management for patients with angina and heart failure.
Manchanda A, Soran O.
J Am Coll Cardiol. 2007 Oct 16;50(16):1523-31. Epub 2007 Oct 1.

Residual high-grade angina after enhanced external counterpulsation therapy.
May O.

Cardiovasc Revasc Med. 2007 Jul-Sep;8(3):161-5.

The role of enhanced external counterpulsation in the treatment of angina and heart failure.
Arora RR, Shah AG.

Can J Cardiol. 2007 Aug;23(10):779-81. Review.

Enhanced external counterpulsation in patients with coronary artery disease-associated erectile dysfunction. Part II: impact of disease duration and treatment courses.
El-Sakka AI, Morsy AM, Fagih BI.
J Sex Med. 2007 Sep;4(5):1448-53. Epub 2007 Jul 18.

Impact of enhanced external counterpulsation on peripheral circulation.
Werner D, Michalk F, Hinz B, Werner U, Voigt JU, Daniel WG.
Angiology. 2007 Apr-May;58(2):185-90.

Effect of enhanced external counterpulsation on medically refractory angina patients with erectile dysfunction.
Lawson WE, Hui JC, Kennard ED, Soran O, McCullough PA, Kelsey SF; for the IEPR Investigators.
Int J Clin Pract. 2007 May;61(5):757-62.

Enhanced external counterpulsation in patients with coronary artery disease-associated erectile dysfunction. Part I: effects of risk factors.
El-Sakka A, Morsy A, Fagih B.
J Sex Med. 2007 May;4(3):771-9. Epub 2007 Apr 13.

Impact of external counterpulsation treatment on emergency department visits and hospitalizations in refractory angina patients with left ventricular dysfunction.
Soran O, Kennard ED, Bart BA, Kelsey SF; IEPR Investigators.
Congest Heart Fail. 2007 Jan-Feb;13(1):36-40. Erratum in: Congest Heart Fail. 2007 Mar-Apr;13(2):124.

Primer: practical approach to the selection of patients for and application of EECP® .
Michaels AD, McCullough PA, Soran OZ, Lawson WE, Barsness GW, Henry TD, Linnemeier G, Ochoa A, Kelsey SF, Kennard ED.
Nat Clin Pract Cardiovasc Med. 2006 Nov;3(11):623-32. Review.

Enhanced external counterpulsation improves exercise tolerance in patients with chronic heart failure.
Feldman AM, Silver MA, Francis GS, Abbottsmith CW, Fleishman BL, Soran O, de Lame PA, Varricchione T; PEECH Investigators.
J Am Coll Cardiol. 2006 Sep 19;48(6):1198-205. Epub 2006 Aug 28.

One year follow-up of patients with refractory angina pectoris treated with enhanced external counterpulsation.
Pettersson T, Bondesson S, Cojocaru D, Ohlsson O, Wackenfors A, Edvinsson L.
BMC Cardiovasc Disord. 2006 Jun 15;6:28.

Mechanisms and evidence for the role of enhanced external counterpulsation in heart failure management.
Silver MA.
Curr Heart Fail Rep. 2006 Apr;3(1):25-32. Review.

Two-year outcomes in patients with mild refractory angina treated with enhanced external counterpulsation.
Lawson WE, Hui JC, Kennard ED, Kelsey SF, Michaels AD, Soran O; International Enhanced External Counterpulsation Patient Registry Investigators.
Clin Cardiol. 2006 Feb;29(2):69-73.

The immediate and long-term outcome of enhanced external counterpulsation in treatment of chronic stable refractory angina.
Loh PH, Louis AA, Windram J, Rigby AS, Cook J, Hurren S, Nikolay NP, Caplin J, Cleland JG.
J Intern Med. 2006 Mar;259(3):276-84.

Two-year clinical outcomes after enhanced external counterpulsation (EECP® ) therapy in patients with refractory angina pectoris and left ventricular dysfunction (report from The International EECP® Patient Registry).
Soran O, Kennard ED, Kfoury AG, Kelsey SF; IEPR Investigators.
Am J Cardiol. 2006 Jan 1;97(1):17-20. Epub 2005 Nov 2.

Frequency and efficacy of repeat enhanced external counterpulsation for stable angina pectoris (from the International EECP® Patient Registry).
Michaels AD, Barsness GW, Soran O, Kelsey SF, Kennard ED, Hui JC, Lawson WE; International EECP® Patient Registry Investigators.
Am J Cardiol. 2005 Feb 1;95(3):394-7.

Enhanced external counterpulsation for ischemic heart disease: what’s behind the curtain?
Bonetti PO, Holmes DR Jr, Lerman A, Barsness GW.
J Am Coll Cardiol. 2003 Jun 4;41(11):1918-25. Review.

Enhanced external counterpulsation as a new treatment modality for patients with erectile dysfunction.
Soran O, Crawford LE, Schneider VM, Feldman AM.
Urol Int. 1998;61(3):168-71.

The multicenter study of enhanced external counterpulsation (MUST-EECP® ): effect of EECP® on exercise-induced myocardial ischemia and anginal episodes.
Arora RR, Chou TM, Jain D, Fleishman B, Crawford L, McKiernan T, Nesto RW.
J Am Coll Cardiol. 1999 Jun;33(7):1833-40.

Long-term prognosis of patients with angina treated with enhanced external counterpulsation: five-year follow-up study.
Lawson WE, Hui JC, Cohn PF.
Clin Cardiol. 2000 Apr;23(4):254-8.

Efficacy of enhanced external counterpulsation in the treatment of angina pectoris.
Lawson WE, Hui JC, Soroff HS, Zheng ZS, Kayden DS, Sasvary D, Atkins H, Cohn PF.

Am J Cardiol. 1992 Oct 1;70(9):859-62.