Effects of external counterpulsation on vasoregulating function and antitrombogenic activity of vascular endothelium in patients with effort angina

The mechanisms of antiischemic and antianginal effects of enhanced external counterpulsation (EECP) are still unknown. To study the mechanisms of the antianginal effect of EECP, a randomized controlled trial was performed. The study included 35 patients with effort angina who received 35 onehour sessions of active and passive EECP. In active EECP group, data showed an improvement in a number of parameters such as: increase in exercise tolerance; reduction in number of angina attack; decrease of nitroglycerin use; improvement in the flowmediated vascular dilatation according to Celermajer test; increase in antithrombin III and plasminogen levels; and decrease in tissue plasminogen activator inhibitor. In sham control group, effects were insignificant. Conclusion: EECP is an effective noninvasive outpatient treatment with significant antianginal effect that improves endothelial function with activation of antithrombogenic activity of vessel wall.