The Effects of External Counter Pulsation Therapy on Circulating Endothelial Progenitor Cells

Study Overview
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Brief Summary
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The objectives of the study are to test the hypothesis that external counter pulsation therapy (ECPT) provides clinical benefit by improving the number and function of endothelial progenitor cells (EPCs) in peripheral blood of patients with angina pectoris.

Detailed Description
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ECPT is a non-invasive approach for increasing blood flow to the heart in patients with myocardial ischemia. ECPT produces beneficial effects in coronary artery disease (CAD) patients. However, the exact mechanisms of ECPT action are not defined yet. Evidence has now accumulated that bone marrow-derived cells with angiogenic capability, termed EPCs, circulate in the blood of adults. EPCs possess the ability to home to sites of ischemia and contribute to neoangiogenesis. We prospectively study CAD patients [Canadian Cardiovascular Society (CCS) angina class II-IV], before and after ECPT , and compare them with age- and sex-matched controls. Peripheral blood CD34+ cells, EPCs (CD34/VEGFR2+ cells), EPC colony forming units (CFUs) and brachial artery endothelial function is assessed prior to and after ECPT. Percent improvement in endothelium-dependent brachial artery flow-mediated dilatation (%FMD) is assessed using high-resolution ultrasound.

Official Title
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The Effects of External Counter Pulsation Therapy (ECPT) on the Number and Function of Circulating Endothelial Progenitor Cells in Patients With Angina Pectoris

Conditions
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Coronary Artery Disease

Intervention / Treatment
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* Procedure: External counter pulsation therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: coronary artery disease CCS angina class II-IV Exclusion Criteria: aortic regurgitation acute myocardial infarction <3 months systemic hypertension >180/110 mm atrial fibrillation deep vein thrombosis phlebitis and hemorrhagic diathesis pregnancy abdominal aortic aneurism metastatic tumor

Ages Eligible for Study
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Minimum Age: 40 Years
Maximum Age: 90 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Crossover Assignment
Masking: None (Open Label)


Arms and Interventions

| Intervention/Treatment |
| --- |
|Procedure: External counter pulsation therapy|nan|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The number of circulating endothelial progenitor cells in peripheral blood (before and one week after treatment) |  |  | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Brachial artery endothelial function (before and one week after treatment) |  |  | 
| CCS angina class (before and one week after treatment) |  |  | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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ECPT, endothelial progenitor cells