Enhanced External Counterpulsation Can Improve Neutrophil to Lymphocyte Ratio in Patients with Chronic Heart Failure

Background: External enhanced Counterpulsation (EECP) is a noninvasive Counterpulsation technique which uses three sets of pneumatic cuffs fasten around the lower extremis. EECP improve coronary perfusion and left ventricle systolic unloading and increase nitric oxide (NO) plasma level which is a vasodilator, anti-thrombotic and anti-inflammatory factor and improve vascular function. In other hand the relation between WBC count, N/L ratio (neutrophil to lymphocyte) and cardiovascular disease had been proved before and demonstrated inflammatory conditions predict long-term mortality in patients with heart failure. The purpose of this study is to evaluate effect of Enhanced external Counterpulsation intervention on noeutrophil-lymphocyte ratio. Methods: Three pairs of EECP compression cuffs devices were fastened at the hips, thighs, legs. Control and ECG monitoring for an hour during 35 sessions period of EECP, all demographic data, underlying diseases (diabetes, chronic kidney disease, etc.), and the dosage and type of medications have been recorded in the checklist before and after the EECP treatment, Complete Blood Count (CBC) has been conducted and the results were recorded on the data collecting form. Results: After intervention WBCs and neutrophil counts reduced with signicant correlation, Lympcytes level increase after EECP intervention. N/R ratio decreased from mean 2.172 ± 0.446 to 1.874 ± 0.342 after EECP with significant correlation (P = 0.0001). Conclusion: EECP treatment had a positive role in inflammatory condition which reduce N/L ratio as an inflammatory index which has an important factor show long-term mortality in patients with heart failure.