A novel external counterpulsation system for coronary artery disease and heart failure: pilot studies and initial clinical experiences
A novel external counterpulsation system for coronary artery disease and heart failure: pilot studies and initial clinical experiences
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一种治疗冠状动脉疾病和心力衰竭的新型体外反搏系统：试点研究和初步临床经验
DOI：
10.1007/s10047-010-0511-2
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发表时间：
2010
影响因子：
1.3
通讯作者：
S. Takamoto
中科院分区：
文献类型：
--
作者：
Tsuyoshi Shimizu;S. Kyo;K. Imanaka;K. Nakaoka;Etsuji Nishimura;T. Okumura;M. Ishii;M. Hisagi;T. Nishimura;N. Motomura;M. Ono;S. Takamoto
体外反搏（ECP）是治疗冠心病或心力衰竭的一种有益的、无创的治疗方法，但仍有许多局限性。我们使用了一种新型的ECP系统，紧凑型CP，其主要特点是双腔袖带，减少了袖带充气的影响和空气压缩机的尺寸。第一个管腔是一个接触套囊，以恒定压力（8 kPa）连接到腿部。第二个管腔是主袖带，其通过驱动压力充气和放气，并与心动周期同步。在这份报告中，我们描述了在总共39名健康志愿者中进行的四项试点研究的结果，以及该系统在三名患者中的初步临床经验。初步研究表明，ECP系统提供了显着的舒张增强和收缩卸载。在40 kPa的驾驶压力下，舒张压/收缩压比值为1.00 ± 0.06，舒适性较好。较高的压力（50-70 kPa）增加了辅助性能，但降低了舒适度。还对1例慢性难治性心绞痛患者和2例心脏手术后心力衰竭患者进行了ECP治疗。临床状况得到改善。未观察到不良反应。我们的新型ECP系统是安全，有效的，并有希望在冠状动脉疾病或心力衰竭的治疗。需要进一步的临床研究来支持该系统的重要性。
External counterpulsation (ECP) is a beneficial and noninvasive treatment for coronary artery disease or heart failure; however, it still has a lot of limitations. We used a novel ECP system, Compact CP, the main feature of which is the double-lumen cuff that reduces the impact of cuff inflation and the size of the air compressor. The first lumen was a contact cuff that was attached to the legs with a constant pressure (8 kPa). The second lumen was a main cuff that was inflated and deflated with a driving pressure and synchronized to the cardiac cycle. In this report, we describe the results of four pilot studies in a total number of 39 healthy volunteers and initial clinical experiences of this system in three patients. The pilot studies demonstrated that the ECP system provided significant diastolic augmentation and systolic unloading. It also achieved a satisfactory diastolic/systolic pressure ratio (1.00 ± 0.06) with a high comfort level at a driving pressure of 40 kPa. Higher pressure (50–70 kPa) increased the assist performance but decreased the comfort level. ECP was also applied with a patient with chronic refractory angina and two patients with postoperative heart failure following cardiac surgery. The clinical conditions improved. No adverse effect was observed. Our novel ECP system is safe, effective, and promising in the treatment of coronary artery disease or heart failure. Further clinical investigations are needed to support the significance of this system.