Effects Of Enhanced External Counterpulsation On Cardiac Remodeling In Patients With Coronary Heart Disease

ObjectiveThis study was to observe the changes of cardiac structure and function in patients with coronary heart disease(CHD)before and after treatment with EECP(Enhanced external counterpulsation)for 15 hours,to investigate the effect of EECP on early cardiac remodeling in patients with coronary heart disease.MethodTwo hundred patients with coronary heart disease were randomly divided into control group(n =100)and EECP group(n = 100).The control group was given anti platelet aggregation drugs,lipid-lowering drugs,beta blockers and other drugs,EECP Group was given the same drugs,at the same time,was given EECP treatment two times a day,each time is half hour,the total treatment time is 15 h.Contrast the changs of E peak,A peak,left atrial diameter(LA),Left ventricular end diastolic diameter(LVEDD),and left ventricular ejection fraction(LVEF)between two groups before and after treatment.Assay the changes of serum N-terminal B-type natriuretic peptide(NT-proBNP)by immunofluorescence.The changes of endothelin-1(ET-1)were detected by chemiluminescence immunoassay.Contrast the changs of NT-proBNP and ET-1 between two groups before and after treatment.ResultsCompared with before treatment: EECP group after treatment,NT-proBNP(90.77±7.23)pg/ml vs(119.36±8.63)pg/ml,ET-1(70.37±33.28)pg/ml vs(134.76±28.69)pg/ml,LA(33.31±6.10)mm vs(37.81±6.05)mm were lower than before treatment,E peak(0.77±0.12)m/s vs(0.59±0.10)m/s,LVEF(66.83±10.05)% vs(56.41±11.19)%,LVEDD(51.13±3.15)mm vs(48.94±4.26)mm were higher than that before treatment,the difference was statistically significant(P < 0.05).There was no significant difference in A peak before and after treatment in EECP group(P>0.05).Control group after treatment,NT-proBNP(103.61±10.33)pg/ml vs(116.21±8.19)pg/ml,ET-1(98.73±34.67)pg/ml vs(116.35±39.68)pg/ml were lower than before treatment,The peak E(0.72±0.09)m/s vs(0.66±0.12)m/s,LVEF(59.90±9.08)% vs(55.60±10.50)% were higher than that before treatment,the difference was statistically significant(P < 0.05).There were no significant change in A,LVEDD and LA values before and after treatment in the control group(P > 0.05).Comparison of two groups before and after treatment: The reduction of NT-proBNP(-29.83±6.19)pg/ml and ET-1(-65.59±16.17)pg/ml in EECP group was significantly lower than that of control group of NT-proBNP(-12.24±3.06)pg/ml and ET-1(-5.97±1.03)pg/ml.the difference was statistically significant(P < 0.05).The elevated value of peak E(0.18± 0.03)m/s and LVEF(11.00±0.36)% in the EECP group was significantly higher than that of the control group of peak E(0.06±0.01)m/s and LVEF(5.01±0.19)%,the difference was statistically significant(P < 0.05).ConclusionEECP can better atrial and ventricular structure in patients with coronary heart disease,improve systolic and diastolic function of the heart.These results suggest that EECP may better early cardiac remodeling in patients with coronary heart disease.