Document Detail

The benefits and safety of external counterpulsation in symptomatic heart failure.
MedLine Citation:
PMID:  17125114     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: External counterpulsation is a safe and effective method of alleviating angina pectoris, but the mechanism of benefit is not understood. OBJECTIVES: To evaluate the safety and efficacy of external counterpulsation therapy in heart failure patients. METHODS: Fifteen symptomatic heart failure patients (subsequent to optimal medical and device therapy) underwent 35 hourly sessions of ECPT over a 7 week period. Before and after each ECPT session we performed pro-B-type natriuretic peptide and brachial artery function studies, administered a quality of life questionnaire, and assessed exercise tolerance and functional class. RESULTS: Baseline left ventricular ejection fraction was 28.1+/-5.8%. ECPT was safe and well tolerated and resulted in a reduction in pro-BNP levels (from 2,245+/- 2,149 pcg/ml to 1,558+/-1206 pcg/ml, P= 0.022). Exercise duration (Naughton protocol) improved (from 720+/-389 to 893+/-436 seconds, P= 0.0001), along with functional class (2.63+/-0.6 vs. 1.93+/-0.7, P= 0.023) and quality of life scores (54+/-22 vs. 67+/-23, P= 0.001). Nitroglycerine-mediated brachial vasodilatation increased (11.5+/-7.3% vs. 15.6+/-5.2%, P=0.049), as did brachial flow-mediated dilation (8.35+/-6.0% vs. 11.37+/-4.9%, P= 0.09). CONCLUSIONS: ECPT is safe for symptomatic heart failure patients and is associated with functional and neurohormonal improvement. Larger long-term randomized studies with a control arm are needed to confirm these initial encouraging observations.
Edo Kaluski; Ziad Gabara; Nir Uriel; Olga Milo; Marina Leitman; Jerald Weisfogel; Vladimir Danicek; Zvi Vered; Gad Cotter
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  The Israel Medical Association journal : IMAJ     Volume:  8     ISSN:  1565-1088     ISO Abbreviation:  Isr. Med. Assoc. J.     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-11-27     Completed Date:  2007-01-09     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  100930740     Medline TA:  Isr Med Assoc J     Country:  Israel    
Other Details:
Languages:  eng     Pagination:  687-90     Citation Subset:  IM    
Department of Cardiology, Assaf Harofeh Medical Center, Zerifin, Israel.
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MeSH Terms
Brachial Artery / physiology
Counterpulsation / adverse effects*,  methods*
Exercise Test
Heart Failure / therapy*
Middle Aged
Quality of Life
Time Factors
Treatment Outcome
Ventricular Dysfunction, Left / therapy
Ventricular Function, Left

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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