Enhanced external counterpulsation improves endothelial function and exercise capacity in patients with ischaemic left ventricular dysfunction

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

doi:10.1111/1440-1681.12263

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Enhanced external counterpulsation improves endothelial function and exercise capacity in patients with ischaemic left ventricular dysfunction

Journal article

Open access

Enhanced external counterpulsation improves endothelial function and exercise capacity in patients with ischaemic left ventricular dysfunction

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

Clinical and experimental pharmacology & physiology, Vol.41(9), pp.628-636

09/2014

DOI: 10.1111/1440-1681.12263

PMCID: PMC4211945

PMID: 24862172

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Abstract

Summary Enhanced external counterpulsation (EECP) therapy decreases angina episodes and improves quality of life in patients with left ventricular (LV) dysfunction (LVD). However, studies have not elucidated the mechanisms of action and overall effects of EECP in patients with LVD. The purpose of the present study was to investigate the effects of EECP on endothelial function in peripheral conduit arteries and exercise capacity (peak Vo2) in patients with LVD. Patients with ischaemic LVD (ejection fraction (EF) 34.5 ± 4.2%; n = 9) and patients with symptomatic coronary artery disease (CAD) and preserved LV function (EF 53.5 ± 6.6%; n = 15) were studied before and after 35 sessions (1 h) of EECP. Brachial and femoral artery flow‐mediated dilation (bFMD and fFMD, respectively) were evaluated using high‐resolution ultrasound. Enhanced external counterpulsation elicited similar significant improvements in the following FMD parameters in the CAD and LVD groups (P ≥ 0.05 between groups for all): absolute bFMD (+53% and +70%, respectively), relative bFMD (+50% and +74%, respectively), bFMD normalized for shear rate (+70% and +61%, respectively), absolute fFMD (+33% and +21%, respectively) and relative fFMD (+32% and +17%, respectively). In addition, EECP significantly improved plasma levels of nitrate/nitrite (+55% and +28%) and prostacyclin (+50% and +70%), as well as peak Vo2 (+36% and +21%), similarly in both the CAD and LVD groups (P ≥ 0.05 between groups for all). Despite reduced LV function, EECP therapy significantly improves peripheral vascular function and functional capacity in CAD patients with ischaemic LVD to a similar degree to that seen in CAD patients with preserved LV function.

coronary artery disease

endothelial function

enhanced external counterpulsation

left ventricular dysfunction

vasoactive biomarkers

Details

Title: Subtitle: Enhanced external counterpulsation improves endothelial function and exercise capacity in patients with ischaemic left ventricular dysfunction
Creators: Darren T Beck - University of Rhode Island
Jeffrey S Martin - Quinnipiac University
Darren P Casey - University of Iowa
Joseph C Avery - University of Florida
Paloma D Sardina - University of Florida
Randy W Braith - University of Florida
Resource Type: Journal article
Publication Details: Clinical and experimental pharmacology & physiology, Vol.41(9), pp.628-636
DOI: 10.1111/1440-1681.12263
PMID: 24862172
PMCID: PMC4211945
NLM abbreviation: Clin Exp Pharmacol Physiol
ISSN: 0305-1870
eISSN: 1440-1681
Number of pages: 9
Grant note: National Institutes of Health, National Heart, Lung and Blood Institutes (RO1 HLO77571)
Language: English
Date published: 09/2014
Academic Unit: Physical Therapy and Rehabilitation Science; Fraternal Order of Eagles Diabetes Research Center
Record Identifier: 9984046833302771

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