Enhanced external counterpulsation in patients with coronary artery disease-associated erectile dysfunction. Part II: impact of disease duration and treatment courses.

Introduction: Enhanced external counterpulsation (EECP) is a noninvasive outpatient treatment used for patients with intractable angina refractory to aggressive surgical and medical treatment. Recent results have demonstrated a positive impact of EECP on patients with ischemic heart disease (IHD)-associated erectile dysfunction (ED).

Aim: To assess the effect of IHD duration and number of EECP courses on efficacy and satisfaction rate of EECP on patients with IHD-associated ED.

Main Outcome Measures: We compared pre- and post-EECP responses to erectile function (EF) domain, Q3 and Q4 of the International Index of Erectile Function score in patients who received one or two courses of EECP and those who had <5- or >or=5-years duration of IHD.

Methods: As mentioned in part I a total of 44 male patients with intractable angina caused by coronary insufficiency were enrolled in this study. Treatment course of EECP consists of 35 1-hour sessions over 7 weeks. Another 35 1-hour sessions over another 7 weeks were offered to patients who received one course and required a second course because of no or minimal improvement from class IV to class III angina after the first course.

Results: Patients who received only one course (N = 34) had significantly higher EF domain, Q3 and Q4, in pre- and post-EECP results than patients who received two courses (N = 10) after they completed the first course. Patients who had <5-years duration of IHD had significantly higher pre- and post EECP than patients who had >or=5 years regarding EF domain, Q3 and Q4. Considering the global efficacy question, overall satisfaction, and angina, there were significant improvements of post EECP in patients with <5 years than in patients with >or=5-years duration of IHD.

Conclusion: The efficacy and satisfaction rate of EECP in patients with IHD-associated ED were negatively influenced by longer duration of IHD and requirement of a second course of EECP.