| Enhanced external counterpulsation improves peripheral artery flow-mediated dilation in patients with chronic angina: a randomized sham-controlled study. | |
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MedLine Citation:
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PMID: 20921442 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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 F(1α), 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 F(1α) (+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. |
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Authors:
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Randy W Braith; C Richard Conti; Wilmer W Nichols; Calvin Y Choi; Matheen A Khuddus; Darren T Beck; Darren P Casey |
Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural Date: 2010-10-04 |
Journal Detail:
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Title: Circulation Volume: 122 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-10-19 Completed Date: 2010-11-05 Revised Date: 2011-10-19 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: 1612-20 Citation Subset: AIM; IM |
Affiliation:
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Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611, USA. rbraith@hhp.ufl.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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6-Ketoprostaglandin F1 alpha
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blood Aged Angina Pectoris / physiopathology* Blood Pressure / physiology Brachial Artery / physiology* C-Reactive Protein / metabolism Chronic Disease Counterpulsation / methods* Cytokines / blood Endothelin-1 / blood Exercise Tolerance / physiology Femoral Artery / physiology* Humans Middle Aged Nitric Oxide / blood Oxygen Consumption / physiology Regional Blood Flow / physiology* Tumor Necrosis Factor-alpha / blood Vasodilation / physiology* |
| Grant Support | |
ID/Acronym/Agency:
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R01 HL077571/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Cytokines; 0/Endothelin-1; 0/Tumor Necrosis Factor-alpha; 10102-43-9/Nitric Oxide; 58962-34-8/6-Ketoprostaglandin F1 alpha; 9007-41-4/C-Reactive Protein |
| Comments/Corrections | |
Comment In:
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Circulation. 2011 Jun 14;123(23):e631
[PMID:
21670237
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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