ENHANCED EXTERNAL COUNTERPULSATION REDUCES INDICES OF CENTRAL BLOOD PRESSURE AND MYOCARDIAL OXYGEN DEMAND IN PATIENTS WITH LEFT VENTRICULAR DYSFUNCTION

Darren T Beck; Darren P Casey; Jeffrey S Martin; Paloma D Sardina; Randy W Braith

doi:10.1111/1440-1681.12367

Back

ENHANCED EXTERNAL COUNTERPULSATION REDUCES INDICES OF CENTRAL BLOOD PRESSURE AND MYOCARDIAL OXYGEN DEMAND IN PATIENTS WITH LEFT VENTRICULAR DYSFUNCTION

Journal article

Open access

ENHANCED EXTERNAL COUNTERPULSATION REDUCES INDICES OF CENTRAL BLOOD PRESSURE AND MYOCARDIAL OXYGEN DEMAND IN PATIENTS WITH LEFT VENTRICULAR DYSFUNCTION

Darren T Beck, Darren P Casey, Jeffrey S Martin, Paloma D Sardina and Randy W Braith

Clinical and experimental pharmacology & physiology, Vol.42(4), pp.315-320

04/2015

DOI: 10.1111/1440-1681.12367

PMCID: PMC4380667

PMID: 25676084

Files and links (1)

url

https://doi.org/10.1111/1440-1681.12367View

Published (Version of record) Open Access

Abstract

Enhanced external counterpulsation (EECP) therapy decreases angina episodes and improves quality of life in patients with left ventricular dysfunction (LVD). However, the underlying mechanisms relative to the benefits of EECP therapy in patients with LVD have not been fully elucidated. The purpose of this study was to investigate the effects of EECP on indices of central hemodynamics, aortic pressure wave reflection characteristics and estimates of LV load and myocardial oxygen demand in patients with LVD. Patients with chronic stable angina and left ventricular ejection fraction (LVEF) <40%, but > 30%, were randomized to either an EECP (LVEF=35.1±4.6%; n=10) or sham-EECP (LVEF=34.3±4.2%; n=7) group. Pulse wave analysis (PWA) of the central aortic pressure waveform (AoPW) and LV function were evaluated by applanation tonometry before and after 35 1-hr sessions of EECP or Sham EECP. EECP therapy was effective in reducing indices of left ventricular wasted energy (LVEw) and myocardial oxygen demand (TTI) by 25% and 19%, respectively. In addition, indices of coronary perfusion pressure (DTI) and subendocardial perfusion (SEVR) were increased by 9% and 30% after EECP, respectively. Our data indicate that EECP may be useful as adjuvant therapy for improving functional classification in heart failure patients through reductions in central blood pressure, aortic pulse pressure, wasted left ventricular energy, and myocardial oxygen demand which suggests improvements in ventricular-vascular interactions.

coronary artery disease

enhanced external counterpulsation

left ventricular dysfunction

central blood pressure

pulse wave analysis

Details

Title: Subtitle: ENHANCED EXTERNAL COUNTERPULSATION REDUCES INDICES OF CENTRAL BLOOD PRESSURE AND MYOCARDIAL OXYGEN DEMAND IN PATIENTS WITH LEFT VENTRICULAR DYSFUNCTION
Creators: Darren T Beck - Department of Kinesiology, University of Rhode Island, Kingston, RI 02881
Darren P Casey - Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, IA 52242
Jeffrey S Martin - Department of Cell Biology and Physiology, Edward Via College of Osteopathic Medicine-Auburn Campus, Auburn, AL 36832
Paloma D Sardina - Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611
Randy W Braith - Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611
Resource Type: Journal article
Publication Details: Clinical and experimental pharmacology & physiology, Vol.42(4), pp.315-320
DOI: 10.1111/1440-1681.12367
PMID: 25676084
PMCID: PMC4380667
NLM abbreviation: Clin Exp Pharmacol Physiol
ISSN: 0305-1870
eISSN: 1440-1681
Grant note: name: National Institutes of Health, National Heart, Lung and Blood Institutes, award: R01 HL077571
Language: English
Date published: 04/2015
Academic Unit: Physical Therapy and Rehabilitation Science; Fraternal Order of Eagles Diabetes Research Center
Record Identifier: 9984047626002771

Metrics

34 Record Views

15 Times Cited - Web of Science