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Andreas Zietzer, Eva Elina Buschmann, Doreen Janke, Lulu Li, Michèle Brix, Heike Meyborg, Philipp Stawowy, Constantin Jungk, Ivo Buschmann, Philipp Hillmeister
AIM: Physical activity is a potent way to impede vascular aging. However, patients who suffer from peripheral artery disease (PAD) are often unable to exercise adequately. For those patients, we have developed individual shear rate therapy (ISRT), which is an adaptation of external counterpulsation and enhances endovascular fluid shear stress to increase collateral growth (arteriogenesis). To evaluate the effects of physical exercise and ISRT on the telomere biology of peripheral blood mononuclear cells (PBMCs), we conducted two clinical trials...
October 22, 2016: Acta Physiologica
Emily J MacKay, Prakash A Patel, Jacob T Gutsche, Stuart J Weiss, John G Augoustides
No abstract text is available yet for this article.
July 28, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Matthew C Black, Erin M Schumer, Michael Rogers, Jaimin Trivedi, Mark S Slaughter
Advanced heart failure (HF) patients not meeting criteria for ventricular assist device or heart transplant with life-limiting symptoms are limited to medical and resynchronization therapy. The Sunshine Heart C-Pulse, based on intra-aortic balloon pump physiology, provides implantable, on-demand, extra-aortic counterpulsation, which reduces afterload and improves cardiac perfusion in New York Heart Association Class III and ambulatory Class IV HF. The C-Pulse reduces New York Heart Association Class, improves 6-min walk distances, inotrope requirements and HF symptom questionnaires...
September 2016: Future Cardiology
Anoshia Raza, Kate Steinberg, Joseph Tartaglia, William H Frishman, Tanush Gupta
External Counterpulsation therapy was first developed over half a century ago as a resuscitative tool to support the failing heart and was based on hemodynamic principles of the intra-aortic balloon pump. Over the course of last few decades, it has evolved into the modern enhanced external counterpulsation (EECP) therapy, which has proven to be a safe, effective, and low-cost noninvasive treatment for patients with debilitating angina and chronic heart failure who are poor candidates for revascularization procedures and have sub-optimal results from other therapies...
August 19, 2016: Cardiology in Review
Ajay Kumar Jha, Vishwas Malik, Parag Gharde, Sandeep Chauhan, Usha Kiran, Milind P Hote
OBJECTIVES: The postoperative course following on-pump coronary artery bypass grafting (CABG) in patients with severe left ventricular (LV) systolic dysfunction is often unpredictable. Therefore, the aim of this study was to identify predictors of poor postoperative outcome in this subset of patients. DESIGN: Prospective observational study SETTING: Single university hospital PARTICIPANTS: Forty patients with severe LV systolic dysfunction undergoing isolated on-pump CABG INTERVENTIONS: None MEASUREMENTS AND MAIN RESULTS: Comprehensive transesophageal echocardiographic examination was performed to obtain the indices of systolic and diastolic LV function after induction of anesthesia...
April 29, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Rohan Shah, Robert M Clare, Karen Chiswell, W Schuyler Jones, A Sreenivas Kumar, Holger Thiele, Richard W Smalling, Praveen Chandra, Marc Cohen, Divaka Perera, Derek P Chew, John K French, Jonathan Blaxill, E Magnus Ohman, Manesh R Patel
BACKGROUND: Non-infarct-related artery (non-IRA) disease is prevalent in patients with ST-segment elevation myocardial infarction (STEMI). We aimed to assess the impact of non-IRA disease on infarct size and clinical outcomes in patients with acute STEMI. METHODS: The Counterpulsation to Reduce Infarct Size Pre-PCI Acute Myocardial Infarction (CRISP-AMI) trial randomized patients to intra-aortic balloon counterpulsation (IABC) vs no IABC prior to percutaneous coronary intervention in patients with acute STEMI...
August 16, 2016: American Journal of Medicine
Shunei Kyo, Takashi Nishimura, Mitsuhiro Kawata, Takuya Ito, Tsuyoshi Shimizu
No abstract text is available yet for this article.
June 20, 2016: Nihon Rinsho. Japanese Journal of Clinical Medicine
Z W Gao, Y Z Huang, H M Zhao, H Sun
OBJECTIVE: To evaluate the effects of intra-aortic balloon counterpulsation (IABP) on mortality in patients with acute myocardial infarction according to the type of revascularization. METHODS: Recruited randomized controlled trials of IABP compared with no-IABP controls in acute myocardial infarction patients from January 1970 to May 2015 were searched from Medline, Embase and Cochrane Library, according to inclusion criteria and exclusion criteria. These data were analyzed using the methods recommended by the Cochrane Collaboration's software RevMan 5...
July 24, 2016: Zhonghua Xin Xue Guan Bing za Zhi
Christina Kolyva, John R Pepper, Ashraf W Khir
The major hemodynamic benefits of intra-aortic balloon pump (IABP) counterpulsation are augmentation in diastolic aortic pressure (Paug ) during inflation, and decrease in end-diastolic aortic pressure (ΔedP) during deflation. When the patient is nursed in the semirecumbent position these benefits are diminished. Attempts to change the shape of the IAB in order to limit or prevent this deterioration have been scarce. The aim of the present study was to investigate the hemodynamic performance of six new IAB shapes, and compare it to that of a traditional cylindrical IAB...
August 2016: Artificial Organs
Eva-Elina Buschmann, Michele Brix, Lulu Li, Janke Doreen, Andreas Zietzer, Meijing Li, Ivo Buschmann, Philipp Hillmeister
BACKGROUND: External counterpulsation therapy enhances blood flow and was shown to improve endothelial function and quality of life in coronary artery disease patients. However, high pressures of up to 300 mmHg may lead to malperfusion of the ischaemic limb. To improve the clinical outcome of patients with peripheral artery disease (PAD), we adjusted external counterpulsation and developed a novel non-invasive approach termed individual shear rate therapy (ISRT). PATIENTS AND METHODS: In the present study, 14 patients with a Fontaine stage IIb and femoral-popliteal PAD underwent 30 hours of ISRT over 5 weeks...
2016: VASA. Zeitschrift Für Gefässkrankheiten
Fawaz Al-Mufti, Nicholas Morris, Shouri Lahiri, William Roth, Jens Witsch, Iona Machado, Sachin Agarwal, Soojin Park, Philip M Meyers, E Sander Connolly, Jan Claassen
INTRODUCTION: Intra-aortic counterpulsation balloon pumps (IABPs) have been widely used to augment hemodynamics in critically ill patients with cardiogenic shock and have recently been proposed as a management strategy for subarachnoid hemorrhage (SAH) patients with neurogenic stress cardiomyopathy (NSC). Prior case series have described the use of IABP as a means to manage cardiogenic shock in this patient population; however, we sought to describe our experience with IABP as a means to wean vasopressor requirement while augmenting hemodynamics and maintaining pressures at goal...
June 2016: Journal of Vascular and Interventional Neurology
M Bilal Iqbal, Abtehale Al-Hussaini, Gareth Rosser, Ramyah Rajakulasingam, Jayna Patel, Katharine Elliott, Poornima Mohan, Maria Phylactou, Rebecca Green, Mark Whitbread, Mark Mason, Richard Grocott-Mason, Robert Smith, Charles Ilsley
BACKGROUND: Despite advances in cardiopulmonary resuscitation, functional survival remains low after out-of-hospital cardiac arrest (OOHCA). Intra-aortic balloon pump (IABP) therapy has recently been shown to augment cerebral blood flow. Whether IABP therapy in the post-resuscitation period improves functional outcomes is unknown. METHODS: We analysed 174 consecutive patients who were successfully resuscitated from an OOHCA between 2011-2013 at Harefield Hospital, London...
May 20, 2016: Heart, Lung & Circulation
Weijia He, Suk-Yin Stephanie Au-Yeung, Margaret Mak, Thomas Wai Hong Leung, Howan Leung, Lawrence Ka Sing Wong
Upper limb weakness and incoordination is a common disability following ischemic stroke. Previous studies have showed that the single application of external counterpulsation (ECP) and intermittent theta burst stimulation (iTBS) can effectively enhance the cortical motor excitability and facilitate recovery. However, it remains uncertain if sequential application of these therapies would further augment the recovery. We hypothesize a synergistic effect of ECP followed by iTBS to upper limb function may happen through improvements in both cerebral perfusion and neuron excitability...
August 2016: Medical Hypotheses
Dianna Thor, Govindasamy Balasekaran, Masato Kawabata, Jason McLaren, Anthony Bert, Jia Bin Fang, Phillis Teng
No abstract text is available yet for this article.
May 2016: Medicine and Science in Sports and Exercise
Govindasamy Balasekaran, Dianna Thor, Masato Kawabata, Jason McLaren, Anthony Bert, Fang Jia Bin, Phillis Teng
No abstract text is available yet for this article.
May 2016: Medicine and Science in Sports and Exercise
Gjin Ndrepepa, Adnan Kastrati
Primary percutaneous coronary intervention (PPCI) has become the mainstay of reperfusion therapy in patients with ST-segment elevation myocardial infarction (STEMI). Despite timely reperfusion by PPCI and restoration of epicardial blood flow in up to 95% of patients, tissue reperfusion remains suboptimal in a sizeable proportion of patients with STEMI. Over the years mechanical and pharmacological strategies to enhance myocardial salvage during PPCI have been developed and used in patients with STEMI. The most common mechanical strategies used in the setting of PPCI include: coronary stenting, direct stenting, mesh-covered stents, self-expanding stents, deferred stenting, thrombectomy, distal protection devices, intra-aortic balloon pumping, left ventricular assist devices and ischaemic conditioning...
June 20, 2016: EuroIntervention
Paloma D Sardina, Jeffrey S Martin, Wojciech K Dzieza, Randy W Braith
AIMS: Enhanced external counterpulsation (EECP) is a noninvasive, non-pharmacologic intervention proven to increase nitric oxide bioavailability in patients with coronary artery disease. The purpose of the present study was to evaluate the potential clinical benefits of EECP on advanced glycation end products (AGEs) and proinflammatory cytokine concentrations in patients with a clinical diagnosis of type II diabetes mellitus (T2DM). METHODS: Thirty subjects (60...
October 2016: Acta Diabetologica
Adam Hunt, Owen Waldin, Hani Slim, Ranjeet Brar
This is a unique case report describing complex limb salvage in a patient who experienced acute limb ischaemia due to a complication of intra-aortic balloon pump (IABP) counterpulsation. This case focuses on a patient who had an IABP counterpulsation device inserted following myocardial infarction, requiring urgent coronary artery bypass grafting for acute coronary syndrome. Postoperatively, the IABP could not be removed, with consequent iliac thrombosis and acute limb ischaemia. Emergency femoral-to-femoral crossover bypass was performed using a polytetrafluoroethylene graft...
2016: BMJ Case Reports
Magnus Ahlbom, Inger Hagerman, Marcus Ståhlberg, Aristomenis Manouras, Gunilla Förstedt, Eline Wu, Lars H Lund
BACKGROUND: Regular enhanced external counterpulsation (EECP) improves exercise capacity possibly through a training effect, but the roles of oxygen consumption (VO2) vs. direct EECP effects (diastolic augmentation, DA-ratio), and their relation to cardiac index (CI) during EECP are unknown. METHODS: We studied eight patients with angina pectoris (median [range] age 72 [53-85], 25% women), who underwent EECP for 35 daily sessions. Before, during and after the first and last sessions, we assessed VO2, DA-ratio and CI...
May 18, 2016: Heart, Lung & Circulation
Jianhang Du, Liang Wang
Growing evidences suggest that long-term enhanced external counter-pulsation (EECP) treatment can inhibit the initiation of atherosclerotic lesion by improving the hemodynamic environment in aortas. However, whether this kind procedure will intervene the progression of advanced atherosclerotic plaque remains elusive and causes great concern in its clinical application presently. In the current paper, a pilot study combining animal experiment and numerical simulation was conducted to investigate the acute mechanical stress variations during EECP intervention, and then to assess the possible chronic effects...
December 2015: Molecular & Cellular Biomechanics: MCB
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