Journal article
Effects of Enhanced External Counterpulsation on Arterial Stiffness and Myocardial Oxygen Demand in Patients with Chronic Angina Pectoris
The American journal of cardiology, Vol.107(10), pp.1466-1472
05/15/2011
DOI: 10.1016/j.amjcard.2011.01.021
PMCID: PMC3087864
PMID: 21420062
Abstract
Enhanced external counterpulsation (EECP) is a non-invasive modality for treatment of symptomatic coronary disease (CAD) in patients not amenable to revascularization procedures. However, the mechanism(s) underlying the benefits of EECP remain unknown. We hypothesized that reductions in arterial stiffness and aortic wave reflection are a therapeutic target for EECP. CAD patients with chronic angina pectoris were randomized (2:1 ratio) to either 35 1-hr sessions of EECP (n=28) or Sham-EECP (n=14). Central and peripheral arterial pulse wave velocity (PWV) and aortic wave reflection (augmentation index; AI
x
) were measured using applanation tonometry before, and after 17 and 35 1-hr treatment sessions. Wasted left ventricular pressure energy and aortic systolic tension time index, markers of left-ventricular myocardial oxygen demand were derived from the synthesized aortic pressure wave. Exercise duration, anginal threshold, and peak oxygen consumption were measured using a graded treadmill test. Central arterial stiffness and AIx were reduced following 17- and 35-sessions in the treatment group. Measures of peripheral arterial stiffness were reduced following 35 sessions in the treatment group. Changes in aortic pressure wave reflection resulted in decreased measures of myocardial oxygen demand and wasted left ventricular energy. No changes in either central or peripheral arterial stiffness were observed in the Sham group. Furthermore, measures of exercise capacity were improved in the EECP group, but unchanged in the Sham group. In conclusion, EECP therapy reduces central and peripheral arterial stiffness, which may explain improvements in myocardial oxygen demand in patients with chronic angina pectoris following treatment.
Details
- Title: Subtitle
- Effects of Enhanced External Counterpulsation on Arterial Stiffness and Myocardial Oxygen Demand in Patients with Chronic Angina Pectoris
- Creators
- Darren P Casey - Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905Darren T Beck - Center for Exercise Science, Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, Gainesville, FL 32611Wilmer W Nichols - Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, FL 32611C. Richard Conti - Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, FL 32611Calvin Y Choi - Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, FL 32611Matheen A Khuddus - Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, FL 32611Randy W Braith - Center for Exercise Science, Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, Gainesville, FL 32611
- Resource Type
- Journal article
- Publication Details
- The American journal of cardiology, Vol.107(10), pp.1466-1472
- DOI
- 10.1016/j.amjcard.2011.01.021
- PMID
- 21420062
- PMCID
- PMC3087864
- NLM abbreviation
- Am J Cardiol
- ISSN
- 0002-9149
- eISSN
- 1879-1913
- Grant note
- R01 HL077571-01 || HL / National Heart, Lung, and Blood Institute : NHLBI
- Language
- English
- Date published
- 05/15/2011
- Academic Unit
- Physical Therapy and Rehabilitation Science; Fraternal Order of Eagles Diabetes Research Center
- Record Identifier
- 9984047667502771
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