Impact of enhanced external counterpulsation on peripheral circulation. Angiology 2007

Enhanced external counterpulsation (EECP) is a noninvasive counterpulsation technique that reduces angina and improves exercise capacity in patients with coronary artery disease. Diastolic coronary perfusion is augmented by pneumatic compression of 3 sets of cuffs wrapped around the lower extremities. Although central hemodynamic changes are well inves-tigated, almost no data exist about the changes of peripheral circulation during EECP. In this study, 12 patients with angina and angiographic evidence of coronary artery disease were treated for 1 hour with EECP. In these patients, peripheral artery disease was excluded by duplex sonography. The patients rested 1 hour before EECP in supine position, and they remained in that position for 1 hour after the procedure. Changes of flow volumes and flow pattern of the posterior tibial artery and the brachial artery were measured by sonography at the end of all 3 periods. Furthermore, we measured the concentration of circulating prostanoids at these 3 time points. Averaged flow volume of the posterior tibial artery decreased to 69% ± 23 % (P <.05) during EECP and increased to 133 % ± 34 % (P <.05) of baseline 1 hour after the procedure. In contrast, the averaged flow volume of the brachial artery increased by 9 % ± 4 % (P <.05) during EECP and returned to baseline values after EECP. The flow pattern of th