@article{3158854,
    title = "Functional electrical stimulation of peripheral muscles improves
endothelial function and clinical and emotional status in heart failure
patients with preserved left ventricular ejection fraction",
    author = "Karavidas, Apostolos and Driva, Metaxia and Parissis, John T. and and Farmakis, Dimitrios and Mantzaraki, Vassiliki and Varounis, Christos and and Paraskevaidis, Ioannis and Ikonomidis, Ignatios and Pirgakis, Vlassios and and Anastasiou-Nana, Maria and Filippatos, Gerasimos",
    journal = "American Heart Journal",
    year = "2013",
    volume = "166",
    number = "4",
    pages = "760-767",
    publisher = "MOSBY-ELSEVIER",
    issn = "0002-8703, 1097-6744",
    doi = "10.1016/j.ahj.2013.06.021",
    abstract = "Background Functional electrical stimulation (FES) improves exercise
capacity, quality of life, emotional stress, and endothelial function in
chronic heart failure with impaired systolic function. We sought to
investigate the effects of FES on the above parameters in patients with
preserved ejection fraction (HFpEF).
Methods Thirty HFpEF patients, 18 female and 12 male, aged 69 +/- 8
years, in New York Heart Association class II or III and with mean
ejection fraction 63% +/- 6%, were randomly (1:1) assigned to a 6-week
FES program or placebo. Assessment was performed at baseline and after
completion of training protocol and included 6-minute walked distance,
quality of life (Kansas City Cardiomyopathy Questionnaire and Minnesota
Living with Heart Failure Questionnaire), depressive symptoms (Beck
Depression Inventory and Zung self-rated depression scores), B-type
natriuretic peptide, endothelial function (flow-mediated dilatation),
and left ventricular diastolic function.
Results A significant improvement in 6-minute walked distance (F =
21.61, P = .001), Kansas City Cardiomyopathy Questionnaire summary (F =
8.68, P = .006), Minnesota Living with Heart Failure Questionnaire (F =
6.43, P = .017), Beck Depression Inventory (F = 6.66, P = .015), Zung (F
= 6.25, P = .019), and flow-mediated dilatation diameter (F = 11.98, P
=.002) was observed in the FES group compared with placebo group; B-
type natriuretic peptide also declined but not significantly (F = 0.249,
P = .622), and there was a tendency toward lower mitral E/e’ wave ratio
(F = 3.066, P = .091).
Conclusion As in heart failure and reduced left ventricular ejection
fraction, FES also improves exercise capacity, quality of life,
emotional status, and endothelial function in HFpEF. Given the lack of
effective evidence-based therapies in these patients, FES warrants
further investigation."
}