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Reduced peripheral vascular reactivity in refractory angina pectoris: Effect of enhanced external counterpulsation

Bondesson, Susanne LU ; Edvinsson, Marie-Louise; Pettersson, Thomas and Edvinsson, Lars LU (2011) In Journal of geriatric cardiology : JGC 8(4). p.215-223
Abstract
To examine if the skin microvascular bed is altered and can be modified by enhanced external counterpulsation (EECP) in patients with chronic refractory angina. Methods Twenty patients diagnosed with refractory angina were divided into EECP (n = 10) or no EECP (n = 10) groups. The data were compared to matched healthy subjects (n = 20). The cutaneous forearm microvascular blood flow was measured by Laser-Doppler flowmetry. The vascular responsiveness to iontophoretic administration of acetylcholine (ACh), sodium nitroprusside (SNP) and local skin warming were studied. Measurements of Canadian Cardiovascular Society (CCS)-class, blood pressure and plasma samples were registered. Results EECP patients showed reduced CCS-class compared to no... (More)
To examine if the skin microvascular bed is altered and can be modified by enhanced external counterpulsation (EECP) in patients with chronic refractory angina. Methods Twenty patients diagnosed with refractory angina were divided into EECP (n = 10) or no EECP (n = 10) groups. The data were compared to matched healthy subjects (n = 20). The cutaneous forearm microvascular blood flow was measured by Laser-Doppler flowmetry. The vascular responsiveness to iontophoretic administration of acetylcholine (ACh), sodium nitroprusside (SNP) and local skin warming were studied. Measurements of Canadian Cardiovascular Society (CCS)-class, blood pressure and plasma samples were registered. Results EECP patients showed reduced CCS-class compared to no EECP (P < 0.05). Both EECP and no EECP (P < 0.05) groups had decreased systolic blood pressure (SBP) as compared to SBP at baseline (P < 0.05). There was no difference in resting blood flow between the two refractory groups at baseline as well as after EECP and seven weeks of follow-up. Responses to heating, the responses to ACh and SNP in the cutaneous microcirculation were lower in both groups of refractory angina patients as compared to healthy subjects (P < 0.05). EECP patients corresponded positively to the treatment shown by reduced plasma level of soluble interleukin-2 receptor and CCS-class. Conclusions Refractory angina patients have reduced responsiveness in their cutaneous microcirculation to ACh, SNP and heat compared to healthy subjects. Although EECP reduced the CCS-class, this effect was not associated with improvements in responsiveness of the cutaneous microcirculation. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
refractory angina pectoris, flowmetry, microcirculation, enhanced, external counterpulsation
in
Journal of geriatric cardiology : JGC
volume
8
issue
4
pages
215 - 223
publisher
Science Press
external identifiers
  • wos:000298666500003
  • scopus:84855414994
ISSN
1671-5411
DOI
10.3724/SP.J.1263.2011.00215
language
English
LU publication?
yes
id
237c6697-c171-4abc-90d5-82e894ddaef0 (old id 2493948)
date added to LUP
2012-05-08 08:19:05
date last changed
2017-05-21 04:10:35
@article{237c6697-c171-4abc-90d5-82e894ddaef0,
  abstract     = {To examine if the skin microvascular bed is altered and can be modified by enhanced external counterpulsation (EECP) in patients with chronic refractory angina. Methods Twenty patients diagnosed with refractory angina were divided into EECP (n = 10) or no EECP (n = 10) groups. The data were compared to matched healthy subjects (n = 20). The cutaneous forearm microvascular blood flow was measured by Laser-Doppler flowmetry. The vascular responsiveness to iontophoretic administration of acetylcholine (ACh), sodium nitroprusside (SNP) and local skin warming were studied. Measurements of Canadian Cardiovascular Society (CCS)-class, blood pressure and plasma samples were registered. Results EECP patients showed reduced CCS-class compared to no EECP (P &lt; 0.05). Both EECP and no EECP (P &lt; 0.05) groups had decreased systolic blood pressure (SBP) as compared to SBP at baseline (P &lt; 0.05). There was no difference in resting blood flow between the two refractory groups at baseline as well as after EECP and seven weeks of follow-up. Responses to heating, the responses to ACh and SNP in the cutaneous microcirculation were lower in both groups of refractory angina patients as compared to healthy subjects (P &lt; 0.05). EECP patients corresponded positively to the treatment shown by reduced plasma level of soluble interleukin-2 receptor and CCS-class. Conclusions Refractory angina patients have reduced responsiveness in their cutaneous microcirculation to ACh, SNP and heat compared to healthy subjects. Although EECP reduced the CCS-class, this effect was not associated with improvements in responsiveness of the cutaneous microcirculation.},
  author       = {Bondesson, Susanne and Edvinsson, Marie-Louise and Pettersson, Thomas and Edvinsson, Lars},
  issn         = {1671-5411},
  keyword      = {refractory angina pectoris,flowmetry,microcirculation,enhanced,external counterpulsation},
  language     = {eng},
  number       = {4},
  pages        = {215--223},
  publisher    = {Science Press},
  series       = {Journal of geriatric cardiology : JGC},
  title        = {Reduced peripheral vascular reactivity in refractory angina pectoris: Effect of enhanced external counterpulsation},
  url          = {http://dx.doi.org/10.3724/SP.J.1263.2011.00215},
  volume       = {8},
  year         = {2011},
}