Effect on treadmill exercise capacity, myocardial ischemia, and left ventricular function as a result of repeated whole-body periodic acceleration with heparin pretreatment in patients with angina pectoris and mild left ventricular dysfunction

Am J Cardiol. 2011 Jan 15;107(2):168-74. doi: 10.1016/j.amjcard.2010.09.007. Epub 2010 Dec 2.

Abstract

Whole-body periodic acceleration (WBPA) has been developed as a passive exercise device capable of improving endothelial function by applying pulsatile shear stress to vascular endothelium. We hypothesized that treatment with WBPA improves exercise capacity, myocardial ischemia, and left ventricular (LV) function because of increased coronary and peripheral vasodilatory reserves in patients with angina. Twenty-six patients with angina who were not indicated for percutaneous coronary intervention and/or coronary artery bypass grafting were randomly assigned to remain sedentary (sedentary group) or undergo 20 sessions of WBPA with the motion platform for 4 weeks (WBPA group) in addition to conventional medical treatment. WBPA was applied at 2 to 3 Hz and approximately ±2.2 m/s² for 45 minutes. We repeated the symptom-limited treadmill exercise test and adenosine sestamibi myocardial scintigraphy. In the WBPA group, the exercise time until 0.1-mV ST-segment depression increased by 53% (p <0.01) and the double product at 0.1-mV ST-segment depression by 23% (p <0.001). Severity score of myocardial scintigraphy during adenosine infusion decreased from 20 ± 10 to 14 ± 8 (p <0.001) and severity score at rest also decreased from 13 ± 10 to 8 ± 10 (p <0.01). On scintigraphic images at rest, LV end-diastolic volume index decreased by 18% (p <0.01) with an augmentation of LV ejection fraction from 50 ± 16% to 55 ± 16% (p <0.01). In contrast, all studied parameters remained unchanged in the sedentary group. In conclusion, treatment with WBPA for patients with angina ameliorates exercise capacity, myocardial ischemia, and LV function.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acceleration
  • Aged
  • Aged, 80 and over
  • Angina Pectoris / complications
  • Angina Pectoris / physiopathology
  • Angina Pectoris / rehabilitation*
  • Anticoagulants / therapeutic use
  • Coronary Circulation / physiology*
  • Disease Progression
  • Electrocardiography
  • Exercise Therapy / methods*
  • Exercise Tolerance*
  • Female
  • Follow-Up Studies
  • Heart Ventricles / diagnostic imaging
  • Heart Ventricles / physiopathology
  • Heparin / therapeutic use*
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Severity of Illness Index
  • Tomography, Emission-Computed, Single-Photon
  • Ventricular Dysfunction, Left / complications
  • Ventricular Dysfunction, Left / physiopathology
  • Ventricular Dysfunction, Left / rehabilitation*
  • Ventricular Function, Left / physiology*

Substances

  • Anticoagulants
  • Heparin