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

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)628-636
Number of pages9
JournalClinical and Experimental Pharmacology and Physiology
Volume41
Issue number9
DOIs
StatePublished - Sep 1 2014
Externally publishedYes

Fingerprint

Counterpulsation
Left Ventricular Dysfunction
Exercise
Coronary Artery Disease
Left Ventricular Function
Brachial Artery
Epoprostenol
Femoral Artery
Nitrites
Nitrates
Stroke Volume
Blood Vessels
Dilatation
Arteries
Quality of Life
Therapeutics

Keywords

  • Coronary artery disease
  • Endothelial function
  • Enhanced external counterpulsation
  • Left ventricular dysfunction
  • Vasoactive biomarkers

ASJC Scopus subject areas

  • Physiology
  • Physiology (medical)
  • Pharmacology

Cite this

Enhanced external counterpulsation improves endothelial function and exercise capacity in patients with ischaemic left ventricular dysfunction. / Beck, Darren T.; Martin, Jeffrey S.; Casey, Darren P.; Avery, Joseph C.; Sardina, Paloma D.; Braith, Randy W.

In: Clinical and Experimental Pharmacology and Physiology, Vol. 41, No. 9, 01.09.2014, p. 628-636.

Research output: Contribution to journalArticle

Beck, Darren T. ; Martin, Jeffrey S. ; Casey, Darren P. ; Avery, Joseph C. ; Sardina, Paloma D. ; Braith, Randy W. / Enhanced external counterpulsation improves endothelial function and exercise capacity in patients with ischaemic left ventricular dysfunction. In: Clinical and Experimental Pharmacology and Physiology. 2014 ; Vol. 41, No. 9. pp. 628-636.
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