EECP May be Useful as Adjuvant Therapy to Reduce Central Blood Pressure and Aortic Pulse Pressure 體外反搏治療可能作為輔助療法,能降低中心 血壓 和主動脈脈壓

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EECP May be Useful as Adjuvant Therapy to Reduce Central Blood Pressure and Aortic Pulse Pressure

Enhanced external counterpulsation (EECP) therapy decreases angina episodes and improves quality of life in patients with left ventricular (LV) dysfunction. However, the underlying mechanisms relative to the benefits of EECP therapy in patients with LV dysfunction have not been fully elucidated. The purpose of this study was to investigate the effects of EECP on indices of central haemodynamics, aortic pressure wave reflection characteristics, and estimates of LV load and myocardial oxygen demand in patients with LV dysfunction. Patients with chronic stable angina and LV ejection fraction < 40% but > 30%, were randomized to either an EECP group (LV ejection fraction = 35.1 ± 4.6%; n = 10) or sham-EECP group (LV ejection fraction = 34.3 ± 4.2%; n = 7). Pulse wave analysis of the central aortic pressure waveform and LV function were evaluated by applanation tonometry before and after 35 1-h sessions of EECP or sham-EECP. Enhanced external counterpulsation therapy was effective in reducing indices of LV wasted energy and myocardial oxygen demand by 25% and 19%, respectively. In addition, indices of coronary perfusion pressure and subendocardial perfusion were increased by 9% and 30%, respectively, after EECP. Our data indicate that EECP may be useful as adjuvant therapy for improving functional classification in heart failure patients through reductions in central blood pressure, aortic pulse pressure, wasted LV energy, and myocardial oxygen demand, which also suggests improvements in ventricular-vascular interactions.

「體外反搏有效降低 血壓  提升左心室功能不全患者的生活質量」

體外反搏(EECP)治療可以減少心絞痛發作,改善左心室(LV – Left Ventricle)功能不全患者的生活質量。然而,對於LV功能不全患者中EECP療法的益處機制尚未完全闡明。本研究旨在探討EECP對於中心血液動力學指標、主動脈壓力波反射特性以及LV負荷和心肌氧需求的影響。慢性穩定心絞痛和LV射血分數(EF)小於40%但大於30%的患者,被隨機分配到EECP組或假EECP組。在接受35次1小時的EECP或假EECP療程前後,使用壓力波分析儀對中心主動脈壓力波形和LV功能進行評估。體外反搏治療有效減少了LV能量浪費指標和心肌氧需求指標25%和19%。此外,EECP後,冠狀灌注壓力指數和心內膜下灌注指數分別增加了9%和30%。我們的數據表明,EECP可能作為輔助療法對於改善心衰患者的功能分級具有益處,通過降低中心 血壓 、主動脈脈壓、LV能量浪費和心肌氧需求,並且可能改善心室-血管相互作用。