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ObjectiveTo observe the effect of the enhanced external counterpulsation （EECP） combined with drug on social function and efficacy in patients with depressive episodes， so as to provide references for the treatment of depressive episodes. MethodsA total of 66 hospitalized patients who was in hospital at department of psychiatry of the Second Xiangya Hospital of Central South University， met the criteria of Diagnostic and Statistical Manual of Mental Disorders，fifth edition（DSM-5） diagnosis of depressive episode or bipolar disorder depressive episode from May 2019 to March 2020 were included by simple random sampling. The participants were divided into study group （n=36） and control group （n=30） according to the random number table method. Both groups received conventional drug treatment， and the study group recieved the EECP intervention at same time. The Depression symptoms and social function were assessed before and after treatment by using Hamilton Depression Scale-24 item （HAMD-24） and Sheehan Disability Scale （SDS）. Treatment efficacy of the two groups was compared. ResultsAfter the intervention， the HAMD-24 and SDS scores in both groups were lower than those before treatment， the differences were statistically significant （t=8.149， 5.791， 8.016， 3.488， P˂0.01）. And the SDS score of the study group was siginficantly lower than that of the control group （t=-3.008， P<0.05）. The total effective rate of treatment in the study group was higher than that of the control group， and the difference was statistically significant （90.63% vs. 63.33%， χ²=8.725， P˂0.05）. ConclusionEECP therapy combined with drug has better efficacy on the patients with depressive episodes， and it can improve social function effectively.
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Objective:To investigate the immediate and lasting effects of enhanced external counterpulsation(EECP)on blood pressure in elderly patients with hypertension.Methods:In this real-world prospective non-randomized controlled study, the elderly hypertensive patients who were newly diagnosed as hypertension or had poor blood pressure control in the Geriatrics Department of Shandong University Qilu Hospital from May 2019 to December 2019, were enrolled as EECP group, and those with systolic blood pressure(SBP)≥180mmHg(1mmHg=0.133 kPa)or had contraindications for EECP treatment were excluded from EECP group(28 cases). Based on the 1∶1 ratio being consistent with the tendency score-matching method, patients' blood pressure was matched at 3 d before the start of the EECP treatment course, with other matched data of baseline data, coexisting disease, cardiovascular medication were choosed as control group(n=28). The EECP group received an additional 36 hours of EECP treatment(6 times/week, 1 hour/time)including lifestyle improvement and anti-hypertensive drugs.The patient's supine blood pressure was collected 3 minutes before each EECP treatment(baseline), 30 minutes during treatment, and 3 minutes after treatment.In the EECP group, family self-measured blood pressure was collected 3 days before the start of the 6-week treatment course(0w), the 6th week(6w)of the treatment course, and the 2nd week(+ 2w), 4th week(+ 4w)and 12th week(+ 12w)after the end of the treatment course, respectively.And the data of control group were collected at the same time point mentioned above.Results:Compared with baseline, the average immediate SBP of elderly hypertensive patients at the 30th minute of EECP treatment was decreased by(5.5±13.6)mmHg( P<0.001), and the average immediate diabolic blood pressure(DBP)was decreased by(1.1±7.5)mmHg( P<0.001). When the baseline SBP was between 160 and 169 mmHg, the probability of a further increase in SBP during treatment was 2.2%(2/89 cases), and when the baseline SBP was between 170 and 179 mmHg, the probability of a further increase in SBP during treatment was 0%(0/57). At 6 weeks, the decrease in SBP was significantly greater in the EECP group than in the control group[(-17.0±8.7)mmHg vs.(-10.5±7.3)mmHg, P<0.01], and the difference continued to + 2w[(-15.5±6.6)mmHg vs.(-10.6±2.5)mmHg, P<0.01]and + 4w[(-13.3±5.4)mmHg vs.(-10.7±2.1)mmHg, P<0.05]. At + 12w, the blood pressure drop was still greater in EECP group than in the control group, but it did not achieve statistically significant differences.Smoking history, history of diabetes, family history of hypertension, and improvement of comorbidities were the key factors that affect the continuous anti-hypertensive effect of EECP. Conclusions:EECP treatment has an immediate effect on lowering blood pressure in elderly hypertensive patients.A 6-week course of EECP treatment has a sustained effect on lowering blood pressure, and the effect can last from 4 to 12 weeks after the end of the course of treatment.
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The aim of this study was to investigate the influence of enhanced external counterpulsation (EECP) on the cardiac function of beagle dogs after prolonged ventricular fibrillation. Twenty-four adult male beagles were randomly divided into control and EECP groups. Ventricular fibrillation was induced in the animals for 12 min, followed by 2 min of cardiopulmonary resuscitation. They then received EECP therapy for 4 h (EECP group) or not (control group). The hemodynamics was monitored using the PiCCO2 system. Blood gas and hemorheology were assessed at baseline and at 1, 2, and 4 h after return of spontaneous circulation (ROSC). The myocardial blood flow (MBF) was quantified by 18F-flurpiridaz PET myocardial perfusion imaging at baseline and 4 h after ROSC. Survival time of the animals was recorded within 24 h. Ventricular fibrillation was successfully induced in all animals, and they achieved ROSC after cardiopulmonary resuscitation. Survival time of the control group was shorter than that of the EECP group [median of 8 h (min 8 h, max 21 h) vs median of 24 h (min 16 h, max 24 h) (Kaplan Meyer plot analysis, P=0.0152). EECP improved blood gas analysis findings and increased the coronary perfusion pressure and MBF value. EECP also improved the cardiac function of Beagles after ROSC in multiple aspects, significantly increased blood flow velocity, and decreased plasma viscosity, erythrocyte aggregation index, and hematocrit levels. EECP improved the hemodynamics of beagle dogs and increased MBF, subsequently improving cardiac function and ultimately improving the survival time of animals after ROSC.
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Animals , Male , Dogs , Counterpulsation/methods , Cardiopulmonary Resuscitation/methods , Hemodynamics/physiology , Case-Control Studies , Disease Models, Animal , Kaplan-Meier EstimateABSTRACT
Objective To investigate the comprehensive improvement of multi-system diseases in elderly patients treated with enhanced external counterpulsation(EECP).Methods Clinical data of an elderly patient with multiple systemic diseases were collected and analyzed.The therapeutic effect of EECP was assessed and EECP-related literatures were reviewed.Results The 62-year-old male patient was diagnosed with coronary atherosclerotic heart disease,unstable angina,New York Heart Association(NYHA)functional class Ⅱ,hypertension(grade 3,very high risk),type 2 diabetes,acute cerebral infarction (recovery period)and benign prostatic hyperplasia.After two courses of EECP treatment,angina in the patient was significantly relieved,cardiac systolic and diastolic function was improved,activity tolerance was increased and the corresponding dosage of therapeutic drugs was reduced.In addition,the patient's blood pressure and blood glucose levels were decreased after versus before treatment and the retinal superficial blood flow was enhanced in both eyes assessed by optical coherence tomography.The frequency and volume of nocturia were reduced.The symptoms of numbness on the left side were improved.Conclusions EECP treatment has shown significant therapeutic effects on multi-system diseases in the elderly patient.EECP is safe,effective and simple and has a broad application prospect in geriatrics.
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Objective To investigate the effect of enhanced external counterpulsation (EECP) on plasma lipoprotein phospholipase A2 (LP-PLA2) levels, vascular endothelial diastolic function in patients with unstable angina. Methods One hundred patients with unstable angina treated in our hospital were randomly divided into routine treatment group (control group n-49) and external counterpulsation group (observation group n = 51, routine treatment plus external counterpulsation therapy, 60 min/time, a total of 30 times). All selected subjects were tested for LP-PLA2 levels on the day of enrollment and on the 30 th day after treatment, and color Doppler ultrasonography was used to detect arterial blood flow-mediated vasodilation (FMD) and nitroglycerin-mediated vasodilation (NMD). Results After treatment in the observation group, LP-PLA2 decreased compared with before treatment, the difference was statistically significant (P < 0.05) , but FMD, NMD were higher than those before treatment, which had statistical difference (P < 0.05). In control group treatment afterwards, LP-PLA2, endothelium-dependent vasodilatation and non-endothelium-dependent vasodilatation did not change significantly before treatment (P> 0.05). Observations between groups showed that the increase in FMD and NMD in the observation group was significantly greater than that in the control group. P < 0.01) , plasma LP-PLA2 levels in the observation group also decreased compared with the control group (P < 0.05). Conclusion Enhanced external counterpulsation can reduce the level of LP-PLA2 in patients and improve endothelial diastolic function under the action of blood flow shear stress.
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Objective To explore the therapeutic effect and prognosis of enhanced external counterpulsation (EECP)on acute cerebral ischemic stroke,to provide clinical evidence for the treatment of patients with acute cerebral ischemic stroke.Methods Total171 patients with acute cerebral ischemic stroke were enrolled and measured the NIHSS and mRS,before EECP,after36 hours EECP,and 3-month after attack.Then contrast the difference of these indicators.Result Compare with the control group,after EECP treatment and after 3-month attack,the scores of NIHSS were statistically significant,(after EECP:44.1％ vs 31.5％;after 3-month attack:55.6％ vs 40.5％),(P＜ 0.05).Compare with the control group,after 3-month attack,the score of mRS in EECP group was declined statistically significant,and the rate of favourable prognosis rise obviously (P＜0.05).Conclusion EECP can effectively improve neurological function and promote health and improve prognosis in the patients with acute cerebral ischemic stroke.
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Objective To study the curative effect of enhanced external counterpulsation(EECP) on the ischemic symptoms,heart function and heart failure markers in the patients with ischemic heart failure.Methods One hundred and eithty patients with ischemic heart failure were divided into the external counterpulsation group and the control group.The treatment group received the EECP therapy.The angina curative effect and heart function(ultrasonic echocardiography,noninvasive hemodynamic monitoring,NYHA heart function grade) as well as heart failure markers changes after treatment were observed in the two groups.Results The effective rate of angina treatment in the counterpulsation group was higher than that in the control group,the difference was statistically significant (P＜0.01).The cardiac output (CO) and cardiac index (CI) in the counterpulsation group were significantly higher than those in the control group,the difference was statistically significant (P＜0.01);the stroke volume (SV),stroke volume index (SI),acceleration index (ACI) and velocity index (Ⅵ) in the counterpulsation group were higher than those in the control group,the difference was statistically significant (P＜0.05);the systemic circulation peripheral vascular resistance (SVR),systemic circulation peripheral vascular resistance index (SVRI) and systolic time rate (STR) in the counterpulsation group were lower than those in the control group,the difference was statistically significant (P＜0.05).There were no statistical difference between the two groups in left ventricular ejection fraction(EF),left ventricular end diastolic diameter(LVEDd) and thoracic cavity fluid volume(TFC) (P＞0.05);there was no statistical difference in NYHA heart function grade between the two groups before treatment.The NYHA heart function grade after treatment in the counterpulsation group was improved compared with that in the control group (P＜0.05).There was no statistical difference in NT-proBNP before treatment between the two groups.The NT-proBNP level after treatment in the counterpulsation group was significantly lower than that in the control group,the difference was statistically sinificant(P＜0.01).Conclusion External counterpulsation can be used for the treatment in the patients with ischemic heart failure,can alleviate the angina symptoms,improves the heart function and heart failure markers.
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Objective To discuss the artery effects of enhanced external counterpulsation for the progressive stroke patients.Methods Ninety-two progressive stroke patients who were treated in the Fourth People's Hospital of Shenzhen from August 2010 to February 2015 were selected and equally divided into the treatment group and the control group based on the random number table.The control group were received conventional therapy,and the treatment group were added treated with enhanced extemal counterpulsation therapy.Results All patients were successfully completed treatment,the C-reactive protein (CRP) and Endothelin-1 (ET-1) were presented decreased significantly after treatment (P＜ 0.05),and the C RP and ET-1 values in the treatment group were (2.09±2.11) mg/L,(13.98±6.30) mg/L,significantly lower than those of the control group((8.12±2.46) mg/L,(46.09± 11.02) mg/L;t =15.309,14.985;P＜0.05).After treatment,the FMD and NMD values in the treatment group were significantly increased from (5.26±1.34)％ to (11.93 ±2.13) ％,and from (13.20±5.33)％ to (22.98±8.34)％,in the control groupand were from (5.27±1.33)％ to (8.10±1.43) ％,and from (13.67±4.10)％ to (16.09±5.12)％ (t=16.934,21.787,8.443,12.345;P ＜0.05),and the value of FMD and NMD in treatment group were significantly higher than in the control group(t =7.982,9.113;P ＜ 0.05).The cardio ankle vascular index (CAVI) and brachial ankle pulse wave velocity (baPWV) values in the treatment group were significantly reduced after treatment,the difference was significant (P＜0.05),and compared with the control group the difference was also statistically significant (t =4.281,8.456;P＜ 0.05).Conclusion Enhanced external counterpulsation for the progressive stroke patients can effectively inhibit the expression of endothelin and inflammatory factors,improve endothelium-dependent relaxation of blood vessels,improve arterial elasticity,and thus play more effective treatment.
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Objective To investigate the effects of enhanced external counterpulsation on coronary heart diseas epatients who suffer from insomnia .Methods Ninety-two cases of coronary heart disease patients with insomnia were divided into observation group and control group randomly ,46 cases in each group .The cases in control group were given routine drug treatment and nursing for coronary heart disease and insomnia .On this base ,the cases in observation group were given EECP .Use the pittsburgh sleep quality index (PSQI) to evaluate the sleep quality of two groups on day of admission and 30d after treatment .The dimensions score and total score of two groups in each time were compared and analyzed .Results After the intervention of 30 d ,PSQI scores in the observation group were lower than those before intervention ,and lower than that of control group ,and there was statistical signifi-cance(P<0 .05) .Conclusion The EECP can relieve the insomnia of coronary heart disease patients ,and improve there sleep quali-ty .
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Objective To explore the curative effect and nursing of enhanced external counterpulsation (EECP) on patients with ischemic cerebral apoplexy. Methods In September 2013 to March 2013 in Shenzhen Futian District People′s Hospital neurology hospital, toally 286 patients with ischemic cerebral apoplexy were randomly divided into two groups, control group and treatment group with 143 cases in each group. The control group used conventional treatment and the treatment group used EECP. The score of clinical nerve function and defect improved Barthel index were compared. Result The score of clinical nerve function defect and improved Barthel index of the treatment group before the treatment were without difference (all P>0.05). The score of clinical nerve function defect and improved Barthel index of the treatment group were less than those of control group after the treatment (all P < 0.05). Conclusion Ischemic stroke patients with positive EECP can significantly increase clinical neural function and life ability , improve patient′s quality of life.
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Objectives To explore the effects of enhanced external counterpulsation(EECP)on the serum level of C-reactive protein and endothelin-1 in patients with cerebral ischemic stroke,to provide clinical evidence for the treat?ment and secondary prevention of patients with cerebral ischemic stroke. Methods Total 187 patients with ischemic stroke were enrolled measure the serum level of C-reactive protein and endothelin-1, before EECP, after36 hours EECP, and one-month after EECP. Then contrast the difference of these indicators. Result After treatment, the serum levels of C-reactive protein and endothelin-1 in EECP group were obviously decrease and the difference was statistically signifi?cant(hs-CRP 60.1%vs. ET-1 40.9%,P0.05). Conclusion EECP can obvi?ously reduce the serum levels of C-reactive protein and endothelin-1 in the patients with ischemic stroke, which indi?cates that EECP can slow atherosclerotic process.
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Objectives To examine the effects of enhanced external counterpulsation on arterial elasticity in stroke patients to provide clinical evidence for secondary prevention of patients with cerebral ischemic stroke. Methods Total 192 patients with ischemic stroke were enrolled and then divided into the EECP (n=107) and control (n=85) group. Auto-matic measurement synchronous atherosclerosis detector was use to measure brachial-ankle pulse wave velocity (BaP-WV) and cardio-ankle vascular index (CAVI). The difference of BaPWV and CAVI were evaluated before, at 36 hours and one month after EECP. Results The BaPWV and CAVI significantly decreased at 36 hours and 1 month after treat-ment in EECP groups compared to either pre-therapy or control groups (all P<0.05). Conclusions EECP can signifi-cantly reduce the BaPWV and CAVI and improve the arterial elasticity in patients with cerebral ischemic stroke. Thus, arterial elasticity may be an important index to evaluate the effects of EECP on cerebral ischemic stroke.
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Objective To conduct a comprehensive study on pulsatile blood flow in arteries by proposing a convenient theoretical research system for hemodynamics. Methods Based on Womersley algorithm for fully developed pulsatile flow, numerical algorithm was introduced to establish the solving and analytical system of hemodynamics based on flow rate in arteries during one cardiac cycle. The flow rate of carotid artery in pig was measured under three blood flow states: the ideal state with a sinusoidal inflow waveform, the normal physiological state and the enhanced external counterpulsation (EECP) state for comprehensive hemodynamic research. Results Important hemodynamic parameters such as the axial speed vector, the wall shear stress (WSS), and the oscillatory shear index (OSI) during one cardiac cycle under the mentioned three flow states were solved respectively. The waveform of flow rate had a certain effect on WSS distributions and OSI level; the EECP performance obviously resulted in a significant increase in the level of WSS (WSS peak in particular) and OSI. Conclusions The solving system developed in this paper can be used for hemodynamics study conveniently and effectively. One of the most important hemodynamic mechanisms that lead to EECP’s good clinical effect may lie in its promotion to WSS level under physiological state, but the effect of OSI on endothelial function of the artery might much smaller than WSS itself; therefore, OSI may not be an ideal hemodynamic index for predicting the lesion of atherosclerosis.
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Objective To investigate the therapeutic effects of enhanced external counterpulsation (EECP) on cerebral edema and cerebral blood flow perfusion with MRI following cardiac arrest (CA) and on successful return of spontaneous circulation (ROSC) by cardiopulmonary resuscitation (CPR) in dogs.Methods Sixteen beagle dogs were induced CA with alternating current on epicardium,then were randomly (random number) divided into the EECP and control group after successful ROSC.MR scanning brain of all animals was carried out by diffusion-weighted imaging (DWI) and perfusion weighted imaging (PWI) before CA and on the first,second and third days after ROSC.Blood pressure,right common carotid artery flow,and intracranial microcirculation perfusion were measured.Results There were no significant differences in mean artery pressure at all intervals between two groups (P ＞ 0.05).There was significant increase in right common carotid artery blood flow and intracranial microcirculation of dogs in EECP group compared with the control group (P ＜ 0.05).Apparent diffusion coefficients (ADC) of water molecule on the first and third days after ROSC were significantly higher in the EECP group than those in the control group (P ＜ 0.05).Ratios of post-ROSC relative cerebral blood flow (RCBF) /original cerebral blood flow were higher in the EECP group than those in the control group on the first,second and third days after ROSC (P ＜ 0.05).Conclusions EECP treatment could improve cerebral blood flow perfusion and relieve ischemic cerebral edema,alleviating brain injury in dogs following CA and successful ROSC.
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@#Objective To observe the effect of enhanced external counterpulsation (EECP) on diabetic retinopathy (DR). Methods 179 patients who accepted EECP combined with medication were as group A and the other 190 patients who accepted medication only were as group B. Their visual acuity, fundus fluorescein angiography (FFA) and optical hemodynamics were compared. Results There was significant improvement in group A with visual acuity, FFA and optical hemodynamics (P<0.05), and the incidence of improvement was more in group A than in group B (P<0.05). Conclusion EECP is effective on diabetic retinopathy.
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Objective To explore the effect of long-term enhanced external counterpulsation(EECP)on endothelium-dependent and endothelium-independent vasorelaxation in the carotid arteries of atherosclerotic piss. Method Totally 18 20-day-old male infant pigs were randomly divided into 3 groups according to feeding given: the normal[control group(n=6),the hypercholesterolemic control group(n=6)and the hypereholesterolemic +EECP group(n=6).Porcine model of hypercholesterolemia was made by feeding high-cholesterol diet.After EECP for 36 hours in the hypercholesterolemic+EECP group(n=6),carotid arterial rings were harvested from all animals and their vaso-relaxation response to different dose of Acetylchofine(Ach)and Sodium nitroprusside (SNP)were detected,respectively.Results As the dose of Ach varying between 10-8 mol/L and 10-5mol/L, endothelium-dependent vasorelaxation ratio of hypereholesterolemic piss with or without EECP treatment was significantly lower than that of the normal control group(P＜0.05),however,endothehum-dependent vasorelax- ation ratio in pigs with EECP treatment was obviously higher compared with hypereholesterolemic pigs without EECP treatment(P＜0.05)as the Ach ranged from 10-7 mol/L to 10-5mol/L.Similarly,as the concentration of SNP ranged fiun 10-8 mol/L to 10-5 mol/L.endothelium-independent vasorelaxafion ratio of both the hypercholesterolemic control group and the hypercholesterolemic+EECP group were significantly lower than that of the normal control group(P＜0.05),and end othelium-independent vasorelaxation ratio of the hypercholesterolemic+EECP group was significantly higher than that of the hypercholesterolemic control group (P＜0.05).Condusions Long-term EECP improves the impaired endothelium-dependent and endothelium independent vasorelaxalion function resulting from atherosclerosis.
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Objective To study the effects of enhanced external counterpulsation (EECP) on the diastolic heart failure in hypertensive patients.Methods 104 hypertensive patients with diastolic heart failure were randomly divided into treatment group and control group,52 patients were given 36 hours of treatment EECP.After 6 months,Doppler ultrasound recordings were obtained from all patients to determine the left ventrlcular diastolic function.Resuits Left ventricular diastolic function index and the left ventrich mass weight index (LVMI) wero impmved after treatment in both groups(P＜0.01),and EECP treated group was better than control group(P＜0.05).Conduslon For hypertensive patients with diastolic heart failure,EECP could not only improve heart diastolic function,but also reverse reconstruction of the left ventricuhr.