How Does EECP Improve Endothelial Function?
External Counterpulsation Therapy is a safe, non invasive treatment that is documented to improve related to Coronary Artery Disease and exercise tolerance. The purpose of this article is to discuss what the exact mechanism that occurs that improves endothelial function in patients that complete a full course of 35 hours.
Testing to assess Peripheral Endothelial Function
There is a relatively new diagnostic tool that is an effective & reproducible for measuring peripheral endothelial function or Endothelial Dysfunction. The test is called Reactive Hyperemia Peripheral Arterial Tonometry or known as RH-PAT for short. This is a quick, noninvasive method to assess peripheral endothelial function by measuring reactive hyperemic response in the finger simultaneous to Non Invasive Brachial Blood Pressure in the arm. The RH-PAT index, a measure of reactive hyperemia, was calculated as the ratio of the digital pulse volume during reactive hyperemia divided by that at rest.
There was a study performed called “EECP Improves Endothelial in Patients with Refractory Angina” which included 23 patients with refractory angina undergoing the 35 day course of EECP Therapy. In each patient RH-PAT measurements were performed before and after the first treatment, another half way through the treatment, and the last EECP session. In addition to those measurements, the RH-PAT was assessed one month after the EECP therapy session was completed.
Can we assume RH-PAT is a useful test for Endothelial Function?
The results were rather significant demonstrating a significant & immediate increase in RH-PAT index after each treatment. In addition, average RH-PAT index at one-month follow-up was significantly higher than that before ECP therapy.
External Counterpulsation Therapy improves peripheral endothelial function with benefits lasting effects persisting at the one-month follow-up in patients. This suggests that improvement in endothelial function may contribute to the clinical benefit of ECP & EECP Therapy in patients with symptoms of Coronary Artery Disease (CAD).