ECP Might Improve the Clinical Outcome by Decreasing the Beat-To-Beat BPV in Stroke Patients 體外反搏治療可能通過降低 中風 患者的心搏血壓變異來改善臨床結果

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EECP Might Improve the Clinical Outcome by Decreasing the Beat-To-Beat BPV in Stroke Patients

BACKGROUND AND PURPOSE:

External counterpulsation (EECP) is a noninvasive method used to enhance cerebral perfusion by elevating the blood pressure in ischemic stroke. However, the response of the beat-to-beat blood pressure variability (BPV) in ischemic stroke patients during EECP remains unknown.

METHODS:

We enrolled recent ischemic stroke patients and healthy controls. Changes in the blood flow velocities in bilateral middle cerebral arteries and the continuous beat-to-beat blood pressure before, during, and after EECP were monitored. Power spectral analysis revealed that the BPV included oscillations at very low frequency (VLF; <0.04 Hz), low frequency (LF; 0.04-0.15 Hz), and high frequency (HF; 0.15-0.40 Hz), and the total power spectral density (TP; <0.40 Hz) and LF/HF ratio were calculated.

RESULTS:

We found that EECP significantly increased the systolic and diastolic blood pressures in both stroke patients and controls. EECP decreased markedly the systolic and diastolic BPVs at VLF and LF and the TP, and the diastolic BPV at HF when compared with baseline. The decreases in diastolic and systolic BPV reached 37.56% and 23.20%, respectively, at VLF, 21.15% and 12.19% at LF, 8.76% and 16.59% at HF, and 31.92% and 23.62% for the total TP in stroke patients, which did not differ from those in healthy controls. The change in flow velocity on the contralateral side was positively correlated with the total TP systolic BPV change induced by EECP (r=0.312, p=0.035).

CONCLUSIONS:

EECP reduces the beat-to-beat BPV when increasing the blood pressure and cerebral blood flow velocity in ischemic stroke patients. EECP might be able to improve the clinical outcome by decreasing the beat-to-beat BPV in stroke patients, and this should be explored further in future studies.

「體外反搏治療降低缺血性 中風 患者的心搏血壓變異」

背景和目的

體外反搏治療(EECP)是一種非侵入性方法,通過提高缺血性 中風 患者的血壓來增強腦灌注。然而,在EECP期間,缺血性 中風 患者的心搏血壓變異(BPV – blood pressure variability)反應仍不清楚。

方法

我們招募了近期缺血性 中風 患者和健康對照組。監測了EECP前、期間和後的雙側中大腦動脈血流速度和持續心搏血壓。功率譜分析顯示BPV包括非常低頻(VLF – very low frquency)、低頻(LF – low frequency)和高頻(HF – high frequency)的振盪,並計算了總功率譜密度(TP – total power spectral density)和LF/HF比率。

結果

我們發現,EECP顯著增加了缺血性 中風 患者和對照組的收縮壓和舒張壓。與基線相比,EECP明顯降低了VLF和LF的舒張壓和收縮壓BPV,以及TP,並且降低了HF的舒張壓BPV。在缺血性 中風 患者中,舒張壓BPV和收縮壓BPV的降低分別達到37.56%和23.20%(VLF),21.15%和12.19%(LF),8.76%和16.59%(HF),以及31.92%和23.62%(總TP),這些結果與健康對照組無異。對側血流速度的變化與EECP引起的總TP收縮壓BPV變化呈正相關。

結論

EECP在提高缺血性 中風 患者的血壓和腦血流速度時降低了心搏血壓變異。EECP可能通過降低 中風 患者的心搏血壓變異來改善臨床效果,這需要進一步在未來的研究中探討。

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