Cardioprotective Effects Of Electro-acupuncture Preconditioning In Coronary Heart Disease Patients Undergoing Non Cardiac Surgery

Associated with increased incidence of coronary heart disease (CHD) in elderlypeople, these non cardiac surgery patients with cardiac risk also increased accordingly.according to some survey for coronary artery disease in elderly patients with preoperativeor had a history of myocardial infarction, perioperative myocardial infarction, orinfarction again, the proportion of more than5.5%, these patients after heart surgery1week,24%-41%in myocardial ischemia, in case of infarction, its mortality rate of50%-83%. Accurate preoperative assessment, sufficient preoperative preparation is beneficialto reducing the occurrence of perioperative cardiovascular events. General research atdomestic and overseas confirmed that beta receptor blockers can improve the prognosisof surgery in elderly patients with coronary heart disease (CHD). But in the latest issue ofnon heart surgery, perioperative use of beta blockers new guide, points out thatperioperative patients are not applicable to beta blockers. Studies have shown that acupuncture may to be useful for coronary heart disease, myocardial ischemia.reveal themechanism of acupuncture against myocardial ischemia, scholars at domestic andoverseas over the years made a large number of experimental and clinical research, fromnerve tracing, nerve electrophysiology, histochemical, immunohistochemical andelectron fiberscope cardiac morphology study of cardiac ischemia after acupuncture, theelectrical physiological, hemodynamic detection of cardiac function, and irradiationmethods of neural endocrine research has made a lot of work.Therefore, this study use electro-acupuncture pretreatment method, analysiscardioprotective effects of different times electro-acupuncture pretreatment on generalanesthesia in elderly patients with coronary heart disease (CHD) undergoing abdominalsurgery,at the same time, to observe cardioprotective effects of electro-acupuncturepreconditioning in coronary heart disease patients undergoing non cardiac surgery.PartI Different times cardioprotective effects ofelectro-acupuncture pretreatment in coronary heart diseasepatients undergoing non cardiac surgeryObjectiveTo observe the different times cardioprotective effects of electro-acupuncturepretreatment in coronary heart disease patients undergoing non cardiac surgery.MethodsSixty patients diagnosed with coronary heart disease were randomly random dividedinto EA group1day,3days,5days, and the control group(n=15). According to thetheory of Traditional Chinese Medicine, bilateral Neiguan (PC6), Lieque (LU7) andYunmen (LU2) were chosen and the acupuncture points were stimulated electrically withthe intensity of2-4（2.34－6.24mA）, and frequency of5/30Hz for30min using theHwato SDZ-II Nerve and Muscle Stimulator (Suzhou Hua Tuo Medical Instruments Co.,Ltd., Suzhou, China). Respectively preoperative, and postoperative2h,24h,72hcollecting venous blood, determination concentrations of troponin I (cTnI) andc-reactive protein (hs-CRP), the above time points of ECG monitoring records, follow-up postoperative incidence of angina pectoris, myocardial ischemia, heart failure andmyocardial infarction, the incidence rate of cardiac death.ResultsIn accordance with test condition, a total of60cases of patients,15cases of patientsin each group. There were no significant differences between the general data set; Fourgroups levels of postoperative troponin I (cTnI)and allergic C-reactive protein (hs CRP)began to rise, comparison between groups have no statistical significance; compared withcontrol group, the incidence of asymptomatic myocardial ischemia at3days and5daysin EA group had significantly lower.ConclusionElectro-acupuncture pretreatment for three days and five days has a certaincardioprotective effect.Part Ⅱ Cardioprotectiveeffects of electro-acupuncturepreconditioning in coronary heart disease patients undergoing noncardiac surgeryObjectiveTo observe the cardioprotective effects of electro-acupuncture preconditioning incoronary heart disease patients undergoing non cardiac surgery, For prevent thehappening of the perioperative cardiac adverse events provide a scientific basis.MethodsEighty patients diagnosed with coronary heart disease were randomly randomdivided into EA group and control group(n=40).(American clinical registration code:NCT01507805). Electro-acupuncture bilateral "Neiguan"(PC6),"Lieque"(LU7),"Yunmen"(LU2)(Suzhou HuaTuo Medical Instruments Co., Ltd., Suzhou, China).Output pulse of the concrete implementation method is as follows: the density wave, thefrequency set to1.5HZ (hydrophobic5-6HZ, dense wave25to30HZ), intensity is setto2-4mA (2.34-6.24mA),30min/d.3d continuous treatment. Respectively preoperative, and postoperative2h,24h,72h collecting venous blood, determinationconcentrations of cTnI and hs-CRP, the above time points of ECG monitoring records,follow-up postoperative incidence of angina pectoris, myocardial ischemia, heart failureand myocardial infarction, the incidence rate of cardiac death. In the preoperative andpostoperative the fifth day do Echocardiography to examination changes in systolic anddiastolic function.ResultsIn76patients with68were completed test, electro-acupuncture pretreatment groupof33cases and the control group35cases.There were no significant differences betweenthe general data set; Two groups of patients with preoperative serum cTnI and hs-CRPlevels are relatively low and there were no significant differences between groups (p>0.05), Troponin I (cTnI) levels of EA group postoperative24h were significantly lower,hs-CRP levels of EA group after postoperative24h of significantly lower than thecontrol group,(p <0.05); Compared with control group, the EA group of postoperativeincidence of asymptomatic myocardial ischemia and arrhythmia were decreased (p<0.05).ConclusionTherefore, electro-acupuncture preconditioning have a protection role in elderlypatients with coronary heart disease undergoing non cardiac surgery.