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Coronary collateral growth by external counterpulsation: a randomised controlled trial
Steffen Gloekler1, Pascal Meier, Stefano F de Marchi
1University Hospital, CH-3010 Bern, Switzerland.
Heart (British Cardiac Society)
|November 10, 2009
Summary
External counterpulsation (ECP) significantly improved coronary collateral function in patients with coronary artery disease. This enhancement in collateral growth is linked to better systemic endothelial function.
Area of Science:
- Cardiology
- Vascular Biology
- Medical Devices
Background:
- External counterpulsation (ECP) efficacy on coronary collateral growth remains uninvestigated in randomized controlled trials.
- Coronary artery disease (CAD) patients often have insufficient collateral circulation.
Purpose of the Study:
- To determine if ECP enhances coronary collateral growth and function.
- To test the hypothesis that ECP improves collateral function during coronary occlusion.
Main Methods:
- A randomized controlled study involving 20 patients with chronic stable CAD.
- Patients received 30 hours of ECP or sham ECP over 4 weeks.
- Coronary collateral function was assessed using collateral flow index (CFI) and myocardial contrast echocardiography.
Main Results:
- ECP significantly increased CFI (p=0.006) compared to sham ECP.
- Coronary collateral conductance showed a trend towards improvement with ECP (p=0.072).
- Improved CFI correlated with enhanced brachial artery flow-mediated dilatation (r=0.584, p=0.027).
Conclusions:
- ECP demonstrates effectiveness in promoting coronary collateral growth.
- Improvements in collateral function are associated with enhanced systemic endothelial function.
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