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Big squeeze could 
aid heart blood flow

August 3, 2001

Strap oversized blood pressure cuffs to your calves and thighs, then inflate them in sequence every 10 seconds or so.

The squeezing sends your blood coursing toward your heart more forcefully than your body normally could.

That’s the gist of an increasingly popular treatment for angina, the chest pain caused by poor blood flow to the heart muscle. A growing number of doctors are promoting ‘‘enhanced external counterpulsation,’’ or EECP.

Although the jury is still out about whether EECP is as good as more established heart treatments, some patients clearly can benefit.

Howard Cherney, 73, a retired Tamarac, Fla., engineer who had a heart attack 19 years ago, says he can now walk 2 1/2 miles a day without a twinge of chest pain after EECP.

‘‘I was getting angina just from sitting in a chair watching TV,’’ Cherney says. ‘‘I couldn’t even walk to my car.’’

Cherney’s doctors recommended bypass surgery or a balloon angioplasty to take care of blockages in his heart arteries. But he was nervous about complications from the operations. Against advice, he got EECP this spring from Dr. Dimitri Pyrros in Margate, Fla.

The therapy has been proved effective in reducing angina in most heart patients, with few side effects and a lower cost than other alternatives.

Patients lie on a table while the cuffs squeeze their legs for an hour. They must go five days a week for seven weeks.

The theory is that forcing blood to the heart reopens small, unused blood vessels that serve to detour blood around the blocked artery. Some researchers say EECP leads to growth of new vessels, but that remains unproven.

‘‘We’ve had patient after patient come in who were told, ‘There’s nothing more we can do for you,’’’’ says Pyrros, who bought an EECP machine two years ago.

EECP has many skeptics, especially among heart specialists who favor medicines, bypass surgery and angioplasty, which involves inflating a balloon to open clogged arteries.

‘‘I view (EECP) as a secondary treatment,’’ says Dr. Howard Bush, cardiology chairman at Cleveland Clinic in Weston, Fla. ‘‘You better have plan A and plan B. This is plan C.’’

The studies are not yet overwhelming and convincing, he says. Medicare and the American College of Cardiology recommend EECP only if mainstream treatments fail or if the patient cannot tolerate them.

Dr. Mark LaPorta, an internist who supervises EECP at the HeartLife center in Aventura, Fla., contends that more studies will prove that it should be used as a first-line treatment. The cost is about $5,000 compared to about $8,000 for angioplasty and $25,000 for bypass.

The side effects are few. Some patients experience rashes, blisters or skin irritations, a danger particularly for diabetics with poor circulation.

More practically, the seven-week treatment may frustrate patients who lack patience and drop out early, Pyrros says.


Knight Ridder Newspapers