EFFECT OF ENHANCED EXTERNAL COUNTER PULSATION ON PLASMALEVEL OF NITRIC OXIDE AND VASCULAR ENDOTHELIAL GROWTH

Background: endothelial dysfunction contributes to the manifestation of stable and unstablecoronary syndromes in pati ents with established coronary art ery dise ase (cad). enh ancedexternal counterpulsation (eecp) is a noninvasive th erapeutic modality for patients with cad,non responsive to medical and /or surgical treatment. the aim of this research was to determinethe long-term effect of eecp on endothelial function via releasing angiog enic factors, no (nitricoxide) and vegf (vascular endothelial growth factor) , in patients with cad.methods: the study was performed on 19 consecutive patients with ischemic coronary arterydisease. all subjects were tr eated with eecp i-h per day, 5 days a week, over 7 weeks (totally 35 h).serum level ofvegf and nitrite (stable no metabolite) concentration was measured before eecp,after 24th day, at the end of course (35th day), and at 1 and 3 months after completion of eecptreatment.results: after 35 hours of eecp, there was a trend toward increase (31.5 ± 14.7%) in nitritelevel compared with baseline (11.12 ± 3.17 vs 9.65 ± 1.36 mgfl) but it wasn 't signific ant. result sof land 3 month follow-up after treatment showed that, th e nitrite levels significantly increasedcompared with the baseline. during the course of eecp therapy, plasma vegf levels increasedprogressively. significant increase in plasma levels of vegf were began from second samplingsession of our study (24th day) and reached to maximum 3 month after eecp therapy.conclusion: in this prospective study that assessed th e effects of eecp on plasma nitriteand vegf levels, it has been demonstrated that eecp progressively increases nitrite and vegflevels during the course of therapy. these significant changes continued 3 months after eecptherapy.