External counterpulsation: Coronary hemodynamics and use in treatment of patients with stable angina pectoris
作者:
Alain Solignac,
Ronald J. Ferguson,
Martial G. Bourassa,
期刊:
Catheterization and Cardiovascular Diagnosis
(WILEY Available online 1977)
卷期:
Volume 3,
issue 1
页码: 37-45
ISSN:0098-6569
年代: 1977
DOI:10.1002/ccd.1810030105
出版商: Wiley Subscription Services, Inc., A Wiley Company
关键词: Coronary sinus blood flow;myocardial metabolism;right atrial pacing;exercise‐induced angina;St‐t segment depression
数据来源: WILEY
摘要:
AbstractExternal pressure counterpulsation (ECP) has been reported to improve the clinical status of patients with angina pectoris. To document the mechanisms for such an improvement left ventricular oxygen consumption and lactate metabolism, coronary sinus blood flow, and cardiac index were studied in 10 patients with angina pectoris 1) prior to and during ECP; and 2) during right atrial pacing before and after 4 consecutive 2‐hour sessions of ECP treatment. During ECP peak early and mean arterial diastolic pressures were significantly raised above control values by 32 and 13% respectively. However, coronary sinus blood flow, left ventricular oxygen consumption and left ventricular lactate extraction, mean systolic arterial pressure and cardiac index were not significantly altered by ECP. Right atrial pacing at 140 beats/min increased coronary sinus blood flow 70% over control values and induced angina and ischemic ST segment changes in 8 patients before and after 4 consecutive treatments of ECP. ECP treatment did not significantly modify the above metabolic and hemodynamic responses at rest or during atrial pacing. Although 5 patients reported improvement in angina symptoms the effect was transitory. No significant improvement over pre ECP‐treatment exercise angina threshold was observed immediately following or at 1 and 3 months post treatment. This method of noninvasive circulatory assistance appears to be of doubtful value in the management of patients with stable angina pecto
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