Enhanced external counterpulsation does not alter arterial stiffness in patients with angina
Enhanced external counterpulsation does not alter arterial stiffness in patients with angina
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DOI：
10.1002/clc.4960271206
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发表时间：
2004-12-01
影响因子：
2.7
通讯作者：
Bagger, JP
中科院分区：
文献类型：
--
作者：
Dockery, F;Rajkumar, C;Bagger, JP
背景资料：增强型体外反搏（EECP）是一种治疗心绞痛的非侵入性方法，可急性增加舒张压并降低心脏后负荷。然而，机制的持续临床效益与此therapy.Hypothesis：该研究旨在确定是否EECP导致改善动脉stiffness.Methods：在所有，22名男性和1名女性心绞痛（年龄63.6+/-6.7岁，平均+/-SD）进行了研究之前和之后的35小时的EECP治疗超过7周。我们测量颈动脉-桡动脉（C-R）脉搏波速度（PW），并使用压平张力计从桡动脉和颈动脉波形推导出主动脉增强指数（AI）。17例患者进行了活动平板运动试验前后7周的EECP.Results：EECP治疗后，尽管在活动平板运动时间和收缩压和舒张压的降低显着改善，有任何动脉僵硬度参数没有显着变化：基线时平均C-R PWV为8.4 ± 0.8 m/sat，EECP 7周后为8.0 ± 1.2 m/s，平均变化：-0.4，95%置信区间（0）：-1.0，+0.2，p = 0.17。术前和术后的平均径向衍生AI分别为25.7 ± 10.4%和24.6 ± 10.8%，平均变化：+1.1%，95%CI：-2.3，+4.5，p = 0.53。中位颈动脉AI术前为31.5%，术后为28.7%;中位变化：-0.5，四分位距：-9.5，+3.5，p = 0.32。19例患者返回6个月的记录，无论是血压，也不是动脉硬度读数与baseline.Conclusion显着不同：增强型体外反搏治疗不会显着改变动脉硬度。除了最初的血压降低，这种疗法的持续临床获益不太可能通过动脉壁机械特性的改变来实现。
Background: Enhanced external counterpulsation (EECP) is a noninvasive treatment for angina that acutely augments diastolic pressure and reduces cardiac afterload. However, the mechanism of the sustained clinical benefit seen with this therapy is not known.Hypothesis: The study aimed to determine whether EECP leads to an improvement in arterial stiffness.Methods: In all, 22 men and I woman with angina (age 63.6+/-6.7 years, mean+/-SD) were studied prior to and after 35 h of EECP therapy over 7 weeks. We measured carotid-radial (C-R) pulse wave velocity (P W), and aortic augmentation index (AI) was derived from radial and carotid artery waveforms using applanation tonometry. Seventeen patients underwent treadmill exercise testing before and after the 7 weeks of EECP.Results: After EECP therapy, despite a significant improvement in treadmill exercise time and a reduction in systolic and diastolic blood pressures, there was no significant change in any arterial stiffness parameters: Mean C-R PWV was 8.4+/-0.8 m/sat baseline and 8.0+/-1.2 m/s after 7 weeks of EECP, mean change: -0.4, 95% confidence interval (0): -1.0, +0.2, p = 0.17. Mean radial-derived AI was 25.7+/-10.4% before and 24.6+/-10.8% after, mean change: +1.1%, 95% Cl: -2.3, +4.5, p = 0.53. Median AI-carotid was 31.5% before and 28.7% after; median change: -0.5, interquartile range: -9.5, +3.5, p = 0.32. Nineteen patients returned for 6-month recordings; neither blood pressure nor arterial stiffness readings were significantly different from baseline.Conclusion: Enhanced external counterpulsation therapy does not significantly alter arterial stiffness. Other than an initial reduction in blood pressure, the sustained clinical benefit seen with this therapy is unlikely to be effected through alterations in arterial wall mechanical properties.