Journal article
Enhanced External Counterpulsation Improves Peripheral Artery Flow-Mediated Dilation in Patients With Chronic Angina: A Randomized Sham-Controlled Study
Circulation (New York, N.Y.), Vol.122(16), pp.1612-1620
2010
DOI: 10.1161/CIRCULATIONAHA.109.923482
PMCID: PMC2963100
PMID: 20921442
Abstract
Background—
Mechanisms responsible for anti-ischemic benefits of enhanced external counterpulsation (EECP) remain unknown. This was the first randomized sham-controlled study to investigate the extracardiac effects of EECP on peripheral artery flow-mediated dilation.
Methods and Results—
Forty-two symptomatic patients with coronary artery disease were randomized (2:1 ratio) to thirty-five 1-hour sessions of either EECP (n=28) or sham EECP (n=14). Flow-mediated dilation of the brachial and femoral arteries was performed with the use of ultrasound. Plasma levels of nitrate and nitrite, 6-keto-prostaglandin F1α, endothelin-1, asymmetrical dimethylarginine, tumor necrosis factor-α, monocyte chemoattractant protein-1, soluble vascular cell adhesion molecule, high-sensitivity C-reactive protein, and 8-isoprostane were measured. EECP increased brachial (+51% versus +2%) and femoral (+30% versus +3%) artery flow-mediated dilation, the nitric oxide turnover/production markers nitrate and nitrite (+36% versus +2%), and 6-keto-prostaglandin F1α (+71% versus +1%), whereas it decreased endothelin-1 (−25% versus +5%) and the nitric oxide synthase inhibitor asymmetrical dimethylarginine (−28% versus +0.2%) in treatment versus sham groups, respectively (all P<0.05). EECP decreased the proinflammatory cytokines tumor necrosis factor-α (−16% versus +12%), monocyte chemoattractant protein-1 (−13% versus +0.2%), soluble vascular cell adhesion molecule-1 (−6% versus +1%), high-sensitivity C-reactive protein (−32% versus +5%), and the lipid peroxidation marker 8-isoprostane (−21% versus +1.3%) in treatment versus sham groups, respectively (all P<0.05). EECP reduced angina classification (−62% versus 0%; P<0.001) in treatment versus sham groups, respectively.
Conclusions—
Our findings provide novel mechanistic evidence that EECP has a beneficial effect on peripheral artery flow-mediated dilation and endothelial-derived vasoactive agents in patients with symptomatic coronary artery disease.
Details
- Title: Subtitle
- Enhanced External Counterpulsation Improves Peripheral Artery Flow-Mediated Dilation in Patients With Chronic Angina: A Randomized Sham-Controlled Study
- Creators
- Randy W BRAITH - Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, Gainesville, United StatesC. Richard CONTI - Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, United StatesWilmer W NICHOLS - Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, United StatesCalvin Y CHOI - Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, United StatesMatheen A KHUDDUS - Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, United StatesDarren T BECK - Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, Gainesville, United StatesDarren P CASEY - Department of Anesthesiology, Mayo Clinic, Rochester, Minn, United States
- Resource Type
- Journal article
- Publication Details
- Circulation (New York, N.Y.), Vol.122(16), pp.1612-1620
- DOI
- 10.1161/CIRCULATIONAHA.109.923482
- PMID
- 20921442
- PMCID
- PMC2963100
- NLM abbreviation
- Circulation
- ISSN
- 0009-7322
- eISSN
- 1524-4539
- Publisher
- Lippincott Williams & Wilkins; Hagerstown, MD
- Language
- English
- Date published
- 2010
- Academic Unit
- Physical Therapy and Rehabilitation Science; Fraternal Order of Eagles Diabetes Research Center
- Record Identifier
- 9984047740302771
Metrics
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