External Counterpulsation Therapy Research Articles

Enhanced External Counterpulsation Outcomes Study: Retrospective Analyses of Data Obtained from Patients at a Single Medical Center in United States

AbstractThe aim was to explore the effectiveness of enhanced external counterpulsation (EECP) therapy in patients with severe angina pectoris/ chronic heart failure symptoms, who were not suitable candidates for invasive treatment. This retrospective study employed a comprehensive methodology that includes individualized treatment, continuous monitoring, and thorough pre- and postprogram evaluations to assess the efficacy of EECP therapy. The standard protocol involved 35 one-hour treatments, with flexibility for extensions based on therapeutic progress. When pre- and posttreatment results were analyzed, EECP improved the original functional class compared with pretreatment. The mean difference in the functional class was 1.32 (0.92), p < 0.0001. Six-minute walk (6MW) distance improved from 383.6 m (110.24) to 423.1 m (121.50) with mean difference of 37.1 (44.99), p < 0.0001. Duke Activity Status Index (DASI) score improved from 3.9 (2.75) to 6.0 (4.17) with mean difference of 2.16 (3.8), p < 0.0001. Training metabolic equivalents (METs) improved from 3.0 (0.74) to 4.0 (1.57) with mean difference of 1.04 (1.2), p < 0.0001. Weekly anginal events decreased from 13.1 (13.19) to 3.2 (7.38) with mean difference of –9.78 (11.7), p < 0.0001. EECP resulted in improvement of angina pectoris functional class, the 6MW distance, reduction in the number of hospitalizations in first year posttreatment, a significant decrease in sublingual nitroglycerin use, improvement of systolic and diastolic blood pressure, and improvement of DASI score.

Abstract 17136: Prospective Cohort Study for Evaluating the Safety and Efficacy of Mobile, Motorized Enhanced Extracorporeal Counterpulsation in Refractory Angina Patients

Introduction: Enhanced external counterpulsation (EECP) therapy is a potential treatment for refractory angina, which refers to persistent symptoms despite optimal treatment. However, the immobility, cost, and lack of individualized pressure control limit the accessibility and clinical implications of EECP. To address these limitations, a new Mobile, Motorized Enhanced Counterpulsation (MECP) device has been developed. Hypothesis: To investigate efficacy of MECP in improving in angina functional class and exercise tolerance in patients with refractory angina and to validate the consistency in outcomes observed with conventional EECP treatment. Methods: This prospective study enrolled patients with symptomatic refractory angina between September 2020 and December 2022 at two tertiary centers in Korea. Baseline and post-treatment assessments included measurements of angina scale, 6-minute walking test, cardiopulmonary exercise test, and central arterial pressure. Results: The study included 71 patients (70.4% male, median age 66 years). After the 10-hour MECP treatment session, 57.7% of patients showed improvement in angina scale based on Canadian Cardiovascular Society classification, with a significant distribution change from 76.8% to 49.3% in class II and from 21.7% to 5.7% in class III (p<0.001). Furthermore, patients demonstrated an increase of 20 meters in the 6-minute walk distance after MECP treatment (464 meters vs. 484 meters, p<0.001). However, there were no statistically significant differences in the baseline characteristics of patients based on their response to MECP. Conclusion : Our study highlights the substantial benefits of MECP in relieving symptoms for patients with refractory angina and suggests its potential for broader clinical applications which merits further investigation.

Impact of Enhanced External Counter-pulsation Therapy on Glycaemic Control in People With Prediabetes and Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis.

Background: Enhanced external counter-pulsation (EECP) therapy is approved for refractory angina in coronary artery disease (CAD). EECP is being explored as a treatment modality in type 2 diabetes mellitus (T2DM). Methods: The Embase, Web of Science, Cochrane Library, MEDLINE (PubMed), ClinicaltTrials. gov, CNKI database, Clinical Trials Registry-india (CTRI), and Google Scholar databases were searched for randomized controlled trials (RCTs) involving patients receiving EECP therapy in the intervention arm. The primary outcome was the changes in glycated haemoglobin (HbA1c). The secondary outcomes were the changes in blood glucose parameters, inflammatory markers and any adverse events. Results: Data from 3 RCTs involving 71 people with T2DM/prediabetes was analysed to find out the impact of EECP therapy compared with placebo. As compared with placebo, patients receiving EECP had significantly lower HbA1C immediately after completion of therapy (mean difference [MD] -0.70%, 95% confidence interval (CI) -0.95. -0.45;p<0.00001), at 2-4 weeks post completion of therapy (MD -1.04%, 95%CI -1.32. -0.77; p<0.00001) and 7-12 weeks after therapy completion (MD -0.98%, 95% CI -1.22, -0.74; p<0.00001). EECP therapy was well tolerated without any increased side effects (risk ratio 2.36, 95% CI 0.11-52.41; p=0.59. Conclusion: EECP therapy is effective in blood glucose and pressure lowering over at least 7-12 weeks of therapy completion. Blood glucose and pressure should be monitored with suitable modulation of drug doses to prevent hypoglycaemia and hypotension in patients with angina undergoing EECP therapy. The PROSPERO registration number is CRD42023434533.

Enhanced external counter pulsation therapy in patients with symptomatic and severe intracranial steno-occlusive disease: a randomized clinical trial protocol.

ClinicalTrials.gov, Identifier: NCT03921827.

Enhancing Cardiovascular Health with Enhanced External Counter pulsation Therapy: A Comprehensive Review

Enhancing Cardiovascular Health with Enhanced External Counter pulsation Therapy: A Comprehensive Review

Tolerability safety and effectiveness of enhanced external counterpulsation versus individual shear rate therapy in patients with lower extremity atherosclerotic disease: Aprospective pilot clinical trial.

We aimed to investigate the tolerability, safety, and effectiveness of enhanced external counterpulsation therapy (EECP) versus individual shear rate therapy (ISRT) in patients with lower extremity atherosclerotic disease (LEAD). Eighteen patients (age: 73.1 ± 6 years) underwent EECP and ISRT, each daily over five consecutive days in a cross-over design with a 1 week resting period in between the two regimens. A quality-of-life questionnaire was used to assess the therapy experience. Oxygen saturation (SO2 ), relative hemoglobin amount (rHb) and blood flow (Flow) in the capillary-venous-system (microcirculation) of the skin were monitored continuously during all therapy sessions using the micro-lightguide spectrophotometer, also known as oxygen to see (O2C). The effects of EECP and ISRT on the renal function and skeletal muscles were evaluated using serial blood and urine tests. EECP therapy had to be terminated early before the end of the 5th session in 10 patients (55.6%) because of discomfort. Four patients (22.2%) experienced signs of critical limb ischaemia under EECP. The total score of the quality-of-life questionnaire was significantly higher (= better tolerated) post-ISRT compared with EECP. Microcirculation monitoring revealed that ISRT significantly increased the SO2 , blood flow and rHb during the therapy. All three parameters remained significantly increased in the observation period after ISRT. The serum levels of creatin kinase and myoglobin increased significantly under EECP. ISRT significantly improves tolerability, safety, and effectiveness over EECP in patients with LEAD.

Cardiac External Counterpulsation Attenuates Myocardial Injury by Regulating NRF2-mediated Ferroptosisin and Oxidative stress Injury.

Objectives To explore the role of the external counterpulsation (ECP) myocardial injury by controlling NRF2-mediated ferroptosis and oxidative stress damage in acute myocardial infarction. Methods Twenty acute myocardial infarction (AMI) participants hospitalized from January 2021 to January 2022 were enrolled. In addition, 20 healthy individuals who had a physical examination at our hospital served as normal controls. Before the AMI patients were given ECP therapy, the blood samples were collected and echocardiography was performed as the data of AMI cohort. Then, the blood samples were collected and echocardiography was performed following the ECP therapy as the data of AMI + ECP cohort. The heart function was assessed by echocardiography test. Results Our findings demonstrated that ECP could reduce heart damage in patients with AMI. In the current study, we found that ECP could reduce heart damage in patients with AMI through increasing the LV-EF% and enhancing LVEDV and LVESV, and the difference was statistically significant (P < 0.05). ECP could reduce the levels of oxidative stress and ferroptosis markers in blood samples of AMI patients, which was through the upregulation of NRF2 and HO-1 expression, and the difference was statistically significant (P < 0.05). Taken together, all data implied that ECP was able to attenuate myocardial injury by regulating NRF2-mediated ferroptosis and oxidative stress in AMI patients, and the difference was statistically significant (P < 0.05). Conclusion Our findings in this research are that cardiac ECP is able to attenuate myocardial injury by regulating NRF2-mediated ferroptosis and oxidative stress injury in AMI patients. This certainly gives the possibility of a clinically effective treatment for AMI patients, although further clinical trials need to be validated.

Abstract 483: External Counterpulsation Therapy (Renew™ NCP-5) For The Treatment Of Mild Cognitive Impairment Due To Alzheimer’s Disease Or Mild Dementia Of The Alzheimer’s Type

Introduction: Research is elucidating vascular impairment in the pathophysiology of Alzheimer’s disease (AD) and as a treatment target. NCP-5 is external counterpulsation (ECP) therapy approved for treating unstable angina and granted FDA Breakthrough Status for mild cognitive impairment (MCI) and AD. It increases cardiac output and improves endothelial function. A study was done to assess NCP-5 on cognitive function. Methods: Randomized, single-blind, sham-controlled; 10 US sites. Subjects 55-85 years (Montreal Cognitive Assessment score ≥11) were given NCP-5 (n=95) or active sham (n=95). Primary endpoint: mean change from baseline in Vascular Dementia Assessment Scale-cognitive subscale (VADAS-Cog) at 12, 18, and 24 weeks, powered for a 2-point change. Results: Primary endpoint met (change, -4.45 points); NCP-5 showed statistically significantly greater improvement from baseline vs active sham on VADAS-Cog. In subjects with type 2 diabetes (T2D; n=36), NCP-5 improved cognition from baseline (change, -17.01 points; p &lt;0.005). NCP-5 was statistically significantly superior to active sham on Alzheimer’s Disease Cooperative Study-Clinical Global Impression of Change at weeks 12 (odds ratio [OR], 2.13; p =0.013) and 24 (OR, 2.56; p =0.002). NCP-5 had a statistically significant decrease on Neuropsychiatric Inventory Aggression Index vs active sham at week 24 ( p =0.041). Neuroimaging showed a decline in right hippocampal volume (HV) that was statistically significantly greater with NCP-5 at week 24 ( p =0.012) and at longitudinal assessment to 12 months ( p =0.008), possibly related to smaller HV seen at baseline with NCP-5. However, the decline in regional cerebral blood flow (rCBF) in the left hippocampus from baseline to month 12 and for the longitudinal assessment was statistically significantly less with NCP-5 than with active sham ( p =0.010 and 0.019, respectively). NCP-5 had a low-risk safety profile (10,644 exposures), and the most common AE was mild skin irritation/injury. Conclusions: Renew NCP-5 improved cognitive performance and global function, particularly in those with T2D. Findings support the role of targeting vascular dysfunction, specifically with NCP-5, for the treatment of MCI and mild dementia of the Alzheimer’s type.

Echocardiographic evaluation of patients with diastolic dysfunction of the left ventricle treated with external counterpulsation

Abstract Funding Acknowledgements Type of funding sources: None. Background The influence of the external counterpulsation (ECP, EECP) on patients with diastolic dysfunction of the left ventricle (LV) is unclear. We aim to determine whether external counterpulsation therapy improves echocardiographic parameters in these patients. Methods We studied 57 patients with stable coronary artery disease undergoing one course of external counterpulsation therapy. The average age of the patients was 63.07 ± 7.44 years (there were 43 (75.4%) male and 14 (24.6%) women). All patients divided into two groups: patients with diastolic dysfunction of the left ventricle (E/e" ratio &amp;gt; 14, total 15 patients, main group) and control group (E/e"&amp;lt; =14, total 42 patients). The mean age of the patients included in the main and control groups was 64.20 ± 5.93 and 62.67 ± 7.93 years (p = 0.36). All patients treated with one course of ECP (EECP) treatment (33,26 ± 3,60 and 32,85 ± 4,56 sessions, p = 0,38). Results from echocardiographic examinations after the treatment in these groups were compared. Echocardiographic assessment included evaluation of the chamber size, chamber volume, ejection fraction of the left ventricle (LV) by 2D and Doppler measurements. Results Echocardiographic parameters for main and control groups before treatment: the diastolic diameter of the LV (cm): 5,65 ± 0,97 and 5,20 ± 0,62 (p = 0,0913); the end-diastolic volume of the LV (ml): 93.53 ± 28.38 and 75.45 ± 25.13 (p = 0.0163); LV stroke volume (ml): 48,57 ± 11,47 and 43,02 ± 10,64 (p = 0,1471); LV ejection fraction (%): 52.83 ± 10.12 and 59.11 ± 9.53 (p = 0.0340); the volume of the left atrium (ml): 73.25 ± 22.79 and 57.86 ± 20.60 (p = 0.0229); tissue Doppler velocity of the mitral annulus (e ", cm/s): 5,89 ± 1,18 and 7,43 ± 1,50 (p = 0,0006); E/e" ratio: 18,85 ± 3,40 and 9,69 ± 1,95 (p &amp;lt; 0,0001). Echocardiographic parameters for the main and control groups after treatment: the diastolic diameter of the LV (cm): 5.53 ± 0.85 and 5.15 ± 0.57 (p = 0.1879); the end diastolic volume of the LV (ml): 92.91 ± 31.29 and 75.15 ± 22.78 (p = 0.0536); LV stroke volume (ml): 50,77 ± 11,49 and 47,01 ± 11,24 (p = 0,2612); LV ejection fraction (%): 56.81 ± 10.50 and 64.06 ± 7.67 (p = 0.0088); the volume of the left atrium (ml): 60.84 ± 16.20 and 55.77 ± 17.53 (p = 0.2388); tissue Doppler velocity of the mitral annulus (e", cm/s): 6,15 ± 1,11 and 7,73 ± 1,90 (p = 0,0037); E/e" ratio: 15.97 ± 5.39 and 10.08 ± 2.81 (p &amp;lt; 0.0001). Statistically significant changes between two groups noted for the left atrium volume: decrease in 12,41 ± 16,33 ml and 2,09 ± 13,72 ml (p = 0,0124) in both groups, and for E/e" ratio: decrease in -2,87 ± 3,94 in the main group and increase in 0,39 ± 2,12 in the control group (p = 0,0003). Conclusion ECP treatment was associated with a decrease in the left atrium volume and E/e’ ratio in patients with diastolic dysfunction of the left ventricle.

Clinical effects of the enhanced external counterpulsation therapy in patients with ischemic chronic heart failure exacerbation COVID-19

Abstract Objectives The aim of the study was to assess the effects of the enhanced external counterpulsation (EECP) therapy as a rehabilitation method in patients with ischemic chronic heart failure (CHF) after COVID-19. Methods 54 (n=54) stable symptomatic CHF (NYHA, functional class I-II; 35%≤LVEF≤50%) subjects (44 male and 10 female; mean age 61±9,8) with prior anamnesis of CAD, at least one myocardial infarction got the exacerbation of CHF after COVID-19 episode. They were randomized in a 2:1 manner into either 35 1-hour 250–300 mm Hg sessions of EECP (n=36; 30 male, 6 female) or Sham-EECP (n=18; 14 male, 4 female). All subjects had been received optimal CHF and CAD drug therapy. At baseline, a month and half a year after EECP course every subject was examined with echocardiography and 6-minute walk test. Results All 36 active EECP treatment group subjects improved by at least 1 NYHA class, 66% of them had no heart failure symptoms post treatment (p&amp;lt;0.01). 84% of treatment group pts. had sustained NYHA class improvement at half a year follow-up (p&amp;lt;0.01), compared with baseline. There was significant difference between LVEF 44±6,5% at baseline vs post-EECP LVEF 50±4,6% (p&amp;lt;0.01) in active EECP treatment group subjects. At the same time there were no significant changes of NYHA class and LVEF in Sham-EECP subjects. No one subject dies after half a year of follow up. Conclusions Enhanced external counterpulsation (EECP) therapy sustainably improves NYHA functional class and LVEF in patients with ischemic CHF exacerbation after COVID-19. Funding Acknowledgement Type of funding sources: None.

The effect of external counterpulsation on intrinsic myocardial function evaluated by speckle tracking echocardiography in refractory angina patients: a randomized controlled trial.

External Counterpulsation (ECP) is one of the therapeutic options in patients with refractory angina inadequately controlled by medical, interventional, or surgical therapy. The 2D Speckle Tracking Echocardiography (2D-STE) method is considered superior in assessing clinical improvement. We would like to evaluate any improvement ofmyocardial intrinsic function using 2D-STE in patients underwent standard ECP protocol (35 sessions). We conducted a double-blind randomized controlled trial. Patients with refractory angina who could not be revascularized conventionally were randomized into two groups: (1) the ECP group (300mmHg) and (2) the Sham/control group (75mmHg). ECP standard therapy was given for 35 sessions (1h/day/session). The 2D-STE data, including longitudinal strain and post systolic index (PSI) were obtained before and after therapy. 43 subjects were analyzed, with 22 subjects in ECP group and 21 control subjects (Sham group). A homogenous baseline strain was found either globally (12.42 ± 4.55 vs 12.00 ± 4.92 [-%]; P = 0.774) or segmentally/regionally (12.63 (0.01-25.16) vs 12.43 (0.01-27.20) [-%]; P = 0.570). There was no statistically significant improvement between groups in the left ventricle longitudinal strain globally (P = 0.535) and segmentally/regionally (P = 0.434). PSI parameters showed improvement in the ECP group (P = 0.049), and segments with PSI ≥ 20% seemed to improve longitudinal strains in the ECP group after therapy (P = 0.042). In conclusion, 35 ECP therapy sessions did not improve either global or segmental/regional left ventricular mechanical function in patients with refractory angina.However, the mechanical function of myocardial segments with PSS tends to improve after ECP therapy.

СОВРЕМЕННЫЙ ВЗГЛЯД НА ВОЗМОЖНОСТИ ОЦЕНКИ СОСТОЯНИЯ МИКРОЦИРКУЛЯТОРНОГО РУСЛА И СПОСОБЫ КОРРЕКЦИИ ЕГО НАРУШЕНИЙ

Investigation of the microcirculatory bed (MVB) has induced heightened interest both theoretical and practical in the medical world of the XX–XXI century. Evaluation of the MVB state has been widely used for revealing pathogenesis and developing an efficient treatment plan in cardiology, diabetology, oncology, dermatovenereology, dentistry, surgery, nephrology, urology, resuscitation and other branches of medicine. It’s worth noticing that evaluation of the microcirculatory parameters should be included into COVID-19 management for optimal medication of the patients especially in severe cases. The article provides a description of the microcirculatory bed, its structure, functions, mechanisms of regulation, causes of damage, and methods for diagnosing disorders. Proper consideration is given to the current techniques used to improve microcirculatory readings. Non-invasive techniques applied in the Republic of Belarus for improving the microcirculatory readings include the method of enhanced external counterpulsation and gravity therapy.

Enhanched External Counterpulsation Therapy Improves Clinical Outcomes, Quality of Life and Functional Effort Capacity in Patients with Symptomatic Heart Failure

ABSTRACT Introduction: Symptomatic chronic heart failure is an important health problem that limits the daily life, quality of life, effort capacity and physiological condition of the patients. In subset of these patients symptoms persist despite optimal medical management. Enhanced External Counterpulsation (EECP) is a non-invasive Food and Drug Administration (FDA) approved therapy which improves symptoms and clinical outcomes in patients with heart failure. However, there is limited data in Turkish cohort. In this study, we investigated the clinical effects of EECP on multiple parameters in Turkish patients with symptomatic chronic heart failure. Material and Methods: Twenty-one individuals who were diagnosed with symptomatic chronic heart failure (left ventricular ejection fraction ≤40%) with New York Heart Association Class (NYHA) II-III were enrolled in the study. Patients were assigned to 35-session EECP treatment. NYHA classification, SF-36 quality of life questionnaire, Minnesota living heart failure questionnaire, quality of life index cardiac version-IV and Beck depression scale were assessed, and 6-minute walk tests were performed before and after EECP treatment. Results: The mean age of the patients was 57.4±12.5 years. EECP therapy resulted in significant improvement in NYHA functional class, quality of life index, effort capacity and pyhsiological condition in all patients without any adverse event (p=0.001). Conclusion: Enchanced external counterpulsation treatment significantly improved clinical parameters and effort capacity in patients with symptomatic heart failure. These results suggest that EECP is an effective and a safe therapy in Class II-III heart failure patients whose symptoms persist despite optimal medical management. Keywords: heart failure, symptom, quality of life, depression, EECP

The Hemodynamic Effect of Enhanced External Counterpulsation Treatment on Atherosclerotic Plaque in the Carotid Artery: A Framework of Patient-Specific Computational Fluid Dynamics Analysis.

Long-term enhanced external counterpulsation (EECP) therapy has been recommended for antiatherogenesis in recent clinical observations and trials. However, the precise mechanism underlying the benefits has not been fully clarified. To quantify the effect of EECP intervention on arterial hemodynamic environment, a framework of numerical assessment was introduced using a parallel computing algorithm. A 3D endothelial surface of the carotid artery with mild atherosclerotic plaque was constructed from images of magnetic resonance angiography (MRA). Physiologic boundary conditions were derived from images of the ultrasound flow velocity spectrum measured at the common carotid artery and before and during EECP intervention. Hemodynamic factors relating to wall shear stress (WSS) and its spatial and temporal fluctuations were calculated and analyzed, which included AWSS, OSI, and AWSSG. Measuring and computational results showed that diastole blood pressure, perfusion, and WSS level in carotid bifurcation were significantly increased during EECP intervention. Mean AWSS level throughout the model increased by 16.9%, while OSI level did not show a significant change during EECP. We thus suggested that long-term EECP treatment might inhibit the initiation and development of atherosclerotic plaque via improving the hemodynamic environment in the carotid artery. Meanwhile, EECP performance induced a 19.6% increase in AWSSG level, and whether it would influence the endothelial functions may need a further study. Moreover, the numerical method proposed in this study was expected to be useful for the instant assessment of clinical application of EECP .

Enhanced external counterpulsation therapy for coronary heart disease after percutaneous coronary intervention in elderly patients

全球人口老龄化加速和冠心病人群经皮冠状动脉介入治疗(PCI)术后生存率的提高，使老年冠心病PCI术后患者人数骤增，这些患者需要更科学系统的心脏康复管理。增强型体外反搏在我国历经40余年的发展，技术相对成熟，临床上广泛应用于各种缺血性疾病的治疗。体外反搏应用于老年人冠心病PCI术后，应遵循临床指南及专家共识的指导，结合此类人群的发病特点，严格把握治疗适应证及禁忌证，制定优化的个体化方案，使患者更大程度地获益。

External Counterpulsation (ECP) Therapy as an Effective Treatment among Patients with Heart Failure undergoing Cardiac Rehabilitation

Background: External counterpulsation (ECP) is a noninvasive procedure using lower limbs pressure cuffs to improve coronary artery blood flow and offload the heart. There is currently no data on the effects of ECP among patients undergoing cardiac rehabilitation (CR). This pilot study aims to determine whether ECP improves exercise capacity among patients with heart failure or post acute myocardial infarction undergoing cardiac rehabilitation. Methods: This is a prospective randomised-controlled pilot study of the effect of ECP in patients with mild to moderate heart failure or post-acute myocardial infarction undergoing CR. Eligible patients were randomised at ratio of 1:1 to either combination of CR and ECP or CR only. All subjects received up to 16 sessions of conventional CR. For the combination arm, subjects received up to 16 one-hour sessions of one-hour ECP therapy following each CR session. All underwent baseline cardiopulmonary testing (CPET) and NT-Pro BNP determination and after completion of study. Results: A total of 4 patients were enrolled in the study from June 2016 to Jan 2017. Two were randomised to combination arm and two into CR arm. Post treatment VO2MAX improved 12 % in the combination arm (23.3±5.6 ml/min/kg from20.8±5.3 ml/min/kgat baseline) compare to 5% in the CR arm (23.0±6.2 ml/min/kg from21.9±2.3 ml/min/kg at baseline). There were no significant difference in the post treatment VO2MAX between groups, p=0.97. There was a 16% increased in post treatment maximum oxygen pulsein the combination group (14.4±1.0ml/beat from12.4±0.5ml/beat at baseline) compare to a 7.8% increased in the CR group (12.4±2.2ml/beat from11.5±1.4ml/beat at baseline). Interestingly, NT proBNP level worsened post treatment in the combination group (447.5±563.6 pre treatment to 472.7±560.5 post treatment), whereas improved in the CR only group (950.5±522.9 pre treatment to 327.5±202.6 post treatment). Conclusion: Cardiac Rehabilitation is known to improve exercise capacity among heart failure patients. ECP can further enhanced maximum oxygen consumption and maximum oxygen pulse in patients with mild to moderate degree of heart failure or post myocardial infarction undergoing cardiac rehabilitation. More studies with larger numbers are needed to prove this benefit of ECP.

GW29-e0825 Effects of the enhanced external counterpulsation therapy in patients with ischemic chronic heart failure

GW29-e0825 Effects of the enhanced external counterpulsation therapy in patients with ischemic chronic heart failure

Usefulness of Individual Shear Rate Therapy, New Treatment Option for Patients With Symptomatic Coronary Artery Disease

The aim of this study was to elucidate if patients with coronary artery disease (CAD), who fail to respond to revascularization procedures, can improve from individual shear rate therapy (ISRT). The ISRT is an adaptation of the external counterpulsation with lower individual treatment pressures based on Doppler-ultrasound measurements during counterpulsation. In contrast to the external counterpulsation therapy, the ISRT is based on the detection of the individual intra-arterial shear rate. Here we report about the first clinical trial of 31 patients with CAD who were enrolled for 30 sessions of ISRT. To determine the therapeutic effect of ISRT we measured the exercise capacity, the arterial stiffness, the aortic wave reflection, and the 24-hour blood pressure before and after 30 treatment sessions. After 6 weeks of accomplished ISRT the walking distance during the 6-minute walking test extended by 78 m (p = 0.007). The total exercise duration in the exercise stress electrocardiogram increased by 84 seconds (p = 0.012) but not the stress intensity (p = 0.086). The pulse wave velocity decreased by 1.2 m/s (p = 0.004) and demonstrated a decrease in arterial stiffness. Pulse wave analysis results demonstrated a progressive decrease in central blood pressure by 12 mmHg (p = 0.008), in pulse pressure by 9 mmHg (p = 0.005), and in augmentation pressure by 5.3 mmHg (p = 0.004). The 24-hour blood pressure decreased systolic by 15 mmHg (p <0.001) and diastolic by 8 mmHg (p = 0.033). The patients also benefited subjectively followed by New York Heart Association and Canadian Cardiovascular Society classifications. In conclusion, the ISRT is an effective treatment for patients with CAD to improve cardiac fitness, arterial stiffness, and to reduce blood pressure.

COMPARISON OF EFFICIENCY OF USE OF EXTERNAL COUNTERPULSATION AND PASSIVE NORMOBARIC HYPOXYTHERAPY IN FEMALE BASKETBALL PLAYERS 10-14 YEARS OLD

The aim of the study was to evaluate the effectiveness of the isolated and combined course application of normobaric hypoxia and enhanced external counterpulsation in young female basketball players. We examined 86 female basketball players aged 10-14 years who are in the sports specialization stage. Physiotherapeutic procedures (enhanced external counterpulsation and normobaric hypoxic therapy in climatic chamber conditions) were conducted in isolation and in combination in breaks between training sessions. Efficacy was assessed on the basis of changes in indicators before and after the course application of the procedures (PWC sample 170, maximum oxygen consumption, stress tests). The greatest increase in general and special working capacity was found in young female basketball players with a 10-day combined course of normobaric hypoxic therapy and external counterpulsation.

GW28-e0024 Effects of enhanced external counterpulsation therapy in patients with stable coronary artery disease and obstructive sleep apnea

The goal of the study was to assess the efficacy of the enhanced external counterpulsation (EECP) therapy in patients with symptomatic stable coronary artery disease (CAD) and severe obstructive sleep apnea (OSA). Open-label, non-controlled clinical study. Forty five (n=45) stable symptomatic CAD