Effects of Enhance External Counterpulsation and Cardiac Rehabilitation on Clinical Parameters and Plasma Nitric Oxide, Endothelin1 and High Sensitive CRP in Patients with Coronary Artery Disease

Abstract

Background and Objectives: Cardiovascular diseases are of the most common causes of death in the world. In this study we have compared the Enhance External Counter Pulsation )EECP) method with cardiac rehabilitation method based on clinical parameters and inflammatory markers in treatment of patients with cardiovascular diseases. Materials and Methods: 44 patients with coronary artery disease were randomized in two groups: EECPgroup (twenty one-hour session (22patients)) and cardiac rehabilitation group twenty sessions with specificprotocol (22 patients). Patient’s information was collected before and after intervention. Outcomes of studywas clinical improvement and increase in serum NO,decrease in hs-CRP and endothelin1 levels. Results: 20% of patients were female and 80% were male in the range of 35 to 75 years old. The hs-CRP level in EECP group was decreased from 1.52±0.7 to 1.27±0.4 µg/ml and was decreased from 1.98±0.6 to 1.75±0.6 µg/ml in cardiac rehabilitation group. NO level was increased from 7.87±0.99 to 8.21±1.27 ng/lit in EECP group and from 8.28±6.49 to 8.31±6.26 ng/lit in cardiac rehabilitation group. And, endothelin1 level decreased in both groups (P=0.38). But was not statistically meaningful. Conclusion: Both cardiac rehabilitation and EECP were effective in improvement of class of angina and quality of life. Increase in serum NO and decrease in hs-CRP and endothelin1 levels, in patients with coronary artery diseases, were seen. But these modalities did not show preferences to each other in therapeutic approaches, at present study.

Keywords: Coronary artery disease, Nitric oxide, Endothelin1, External counterpulsation