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Long-term effect of enhanced external counterpulsation on endothelial function in the patients with intractable

Mohammad Hashemi1, Marzieh Hoseinbalam, Majid Khazaei

  • 1Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Heart, Lung & Circulation
|August 19, 2008
PubMed

Insights

Enhanced external counterpulsation (EECP) acutely improves endothelial function in patients with ischaemic cardiomyopathy. However, these benefits on endothelial function do not persist long-term, returning to baseline one month after treatment cessation.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Noninvasive Cardiovascular Techniques

Background:

  • Enhanced external counterpulsation (EECP) is a noninvasive pneumatic therapy known to benefit patients with coronary artery disease.
  • Ischaemic cardiomyopathy presents challenges in managing cardiac function and vascular health.

Purpose of the Study:

  • To evaluate the long-term impact of EECP on endothelial function in patients diagnosed with ischaemic cardiomyopathy.
  • To assess changes in endothelium-dependent and -independent vasodilation following EECP therapy.

Main Methods:

  • A cohort of 15 patients with ischaemic cardiomyopathy underwent a 7-week EECP treatment course (35 hours total).
  • Endothelial function was assessed using flow-mediated dilation (FMD) for endothelium-dependent relaxation and nitroglycerine-mediated dilatation (NMD) for endothelium-independent relaxation.
  • Measurements were taken before, during, and after the EECP course, with a follow-up assessment one month post-therapy.

Main Results:

  • A significant improvement in FMD index was observed after 35 hours of EECP compared to baseline (10.95% vs. 7.40%, p<0.05).
  • Nitroglycerine-mediated dilatation (NMD) showed no significant alteration during the EECP therapy.
  • One month after completing EECP, the FMD index returned to baseline levels (7.51% vs. 7.40%, p<0.05), indicating a transient effect on endothelial function.

Conclusions:

  • EECP demonstrates an acute positive effect on endothelial function in patients with ischaemic cardiomyopathy.
  • The improvement in endothelial function appears to be temporary, suggesting it may not be the primary mechanism for any long-term benefits of EECP.
  • Further research is needed to explore alternative mechanisms underlying the sustained effects of EECP in managing ischaemic cardiomyopathy.
Abstract

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