Enhanced External Counterpulsation Effects on Venous Leg Symptoms

Background: Venous diseases encompass a large spectrum of abnormalities in the venous system with complaints, such as aching and swelling. Enhanced external counterpulsation, proven safe and effective in patients with coronary artery disease and chronic heart failure, is a technique that increases venous return and augments diastolic blood pressure. This study assessed the effects of enhanced external counterpulsation on symptoms of venous disease using the Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Symptoms questionnaire.

Methods: This study was designed prospectively for evaluating venous symptoms before and after enhanced external counterpulsation treatment. The study population consisted of 30 consecutive patients who were admitted to the cardiology clinic. The Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Symptoms questionnaire was applied to assess venous symptoms one day before and after enhanced external counterpulsation treatment.

Results: The mean age of the patients was 64.62 ± 9.67 years. After 35 hours of enhanced external counterpulsation, 28 patients (93%) had at least 1 New York Heart Association functional class reduction compared with baseline and 43% of patients had 2 New York Heart Association functional classes improvement. The New York Heart Association class significantly decreased after enhanced external counterpulsation treatment (P<.001). There was a significant improvement in their swelling and night cramps symptoms compared with baseline (P<.001 and P =.05, respectively). Also, The left ventricular ejection fraction significantly increased after the enhanced external counterpulsation treatment (P =.02).

Conclusions: The findings obtained in the present study suggested that patients treated with enhanced external counterpulsation showed a significant reduction in swelling and night cramps symptoms. Although the total VEIN score did not change after the enhanced external counterpulsation procedure, improvement in swelling and night cramps underlines the beneficial effects of enhanced external counterpulsation through the venous vascular territory.