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Observational Study
. 2013 Sep 11:14:193.
doi: 10.1186/1471-2369-14-193.

Effect of enhanced external counterpulsation treatment on renal function in cardiac patients

Prajej Ruangkanchanasetr  1 , Nithi Mahanonda, Ongkarn Raungratanaamporn, Piyanuj Ruckpanich, Chagriya Kitiyakara, Amnart Chaiprasert, Surawat Adirekkiat, Dollapas Punpanich, Somlak Vanavanan, Anchalee Chittamma, Thanom Supaporn
Affiliations
Observational Study

Effect of enhanced external counterpulsation treatment on renal function in cardiac patients

Prajej Ruangkanchanasetr et al. BMC Nephrol. .

Abstract

Background: Enhanced external counterpulsation (EECP) enhances coronary perfusion and reduces left ventricular afterload. However, the role of EECP on renal function in cardiac patients is unknown. Our aim was to assess renal function determined by serum cystatin C in cardiac patients before and after EECP treatment.

Methods: A prospective observational longitudinal study was conducted in order to evaluate renal function using serum cystatin C (Cys C) and estimated glomerular filtration rate (GFR) after 35 sessions of EECP treatment in 30 patients with chronic stable angina and/or heart failure. The median (IQR) time for follow-up period after starting EECP treatment was 16 (10-24) months.

Results: Cys C significantly declined from 1.00 (0.78-1.31) to 0.94 (0.77-1.27) mg/L (p < 0.001) and estimated GFR increased from 70.47 (43.88-89.41) to 76.27 (49.02-91.46) mL/min/1.73 m(2) (p = 0.006) after EECP treatment. Subgroup analysis showed that patients with baseline GFR <60 mL/min/1.73 m(2) or NT-proBNP >125 pg/mL had a significant decrease in Cys C when compared to other groups (p < 0.01).

Conclusions: The study demonstrated that EECP could improve long-term renal function in cardiac patients especially in cases with declined renal function or with high NT-proBNP.

Trial registration: The study was registered in the clinical trial as International Standard Randomized Controlled Trial Number ISRCTN11560035.

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Figures

Figure 1
Figure 1
Scatter plot shows relationship between GFR and NT-proBNP at baseline.
See this image and copyright information in PMC

References

    1. Ronco C, Haapio M, House AA, Anavekar N, Bellomo R. Cardiorenal syndrome. J Am Coll Cardiol. 2008;52:1527–1539. doi: 10.1016/j.jacc.2008.07.051. - DOI - PubMed
    1. Anavekar NS, McMurray JJV, Velazquez EJ, Solomon SD, Kober L, Rouleau JL, White HD, Nordlander R, Maggioni A, Dickstein K, Zelenkofske S, Leimberger JD, Califf RM, Pfeffer MA. Relation between renal dysfunction and cardiovascular outcomes after myocardial infarction. N Engl J Med. 2004;351:1285–1295. doi: 10.1056/NEJMoa041365. - DOI - PubMed
    1. Hillege HL, Nitsch D, Pfeffer MA, Swedberg K, McMurray JJV, Yusuf S, Granger CB, Michelson EL, Östergren J, Cornel JH, de Zeeuw D, Pocock S, van Veldhuisen DJ. Renal function as a predictor of outcome in a broad spectrum of patients with heart failure. Circulation. 2006;113:671–678. doi: 10.1161/CIRCULATIONAHA.105.580506. - DOI - PubMed
    1. Arora RR, Chou TM, Jain D, Fleishman B, Crawford L, McKiernan T, Nesto RW. The multicenter study of enhanced external counterpulsation (MUST-EECP): effect of EECP on exercise-induced myocardial ischemia and angina episodes. J Am Coll Cardiol. 1999;33:1833–1840. doi: 10.1016/S0735-1097(99)00140-0. - DOI - PubMed
    1. Michaels AD, McCullough PA, Soran OZ, Lawson WE, Barsness GW, Henry TD, Linnemeier G, Ochoa A, Kelsey SF, Kennard ED. Primer: practical approach to the selection of patients for and application of EECP. Nat Clin Pract Cardiovasc Med. 2006;3:623–632. doi: 10.1038/ncpcardio0691. - DOI - PubMed

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