| Background:Being a part of heart rehabilitation,Enhanced external counterpulsation(EECP)is another important treatment method for coronary heart disease.It is a noninvasive intervention proven to be safe and effective in patients with coronary artery disease in large clinical trials.The clinical benefits of EECP extend well beyond the time period of any hemodynamic effects,but the cause of this prolonged effect is not fully elucidated.Experimental evidence is emerging that endostatin(ES)is causally involved incardiovascular diseases.As the inhibitor of angiogenesis,ES is closely connected with collateral circulation,neointimal formation and circulating endothelial progenitor cells.It has been reported that exercise has an influence on the serum endostatin.It is seem that long-time exercise is associated with low level of serum endostatin in patients with coronary artery disease.Nevertheless,being another form of exercise,enhanced external counterpulsation can be seen as a passive and long-time exercise,with 35 hours treatment for lasting 7 weeks.So,whether EECP will affect serum endostatin in patients with coronary artery disease,which has not been reported.Objective:The purpose of the present study was to evaluate the influence of EECP on serum endostatin in patients with coronary artery disease,and to provide thoughts of the potential mechanism of EECP for its long-time benefits.Methods:Sixty patients visiting our department with coronary artery disease were randomly divided into EECP group(30 cases)and control group(30 cases).Besides standardized drug treatment,EECP group took part in 35 1-h sessions of EECP.The clinical and biochemical characteristics of all subjects was collected.Serum samples of both groups were collected to detect endostatin concentrations before and after treatment.The effects had also been evaluated.Statistical analysis was performed using the statistical software SPSS 20.0.Results:There is no significant difference between two groups in sex,age,BMI,glucose,glycated hemoglobin,total cholesterol,triglycerides,LDL,HDL,apolipoprotein Al,apolipoprotein B,serum creatinine,smoking ratio,hypertension ratio,diabetes ratio,hyperlipidemia ratio,medication history,and coronary artery lesion branches,etc.The improvement of clinical symptoms of the EECP group was significantly better than that of the control group,(93.3%vs 56.7%),P<0.05.The serum endostatin levels in the two groups before treatment were not significantly different(t =-0.846 P= 0.401).EECP significantly reduced serum endostatin compared to baseline,(117.5±25.7ng/ml vs 127.4±28.8ng/ml),t = 9.309 P<0.01.While the serum endostatin in control group is not statistically significant post-EECP to baseline,(132.7±25.9ng/ml vs 133.5126.4ng/ml),t = 1.219 P = 0.233.Compared to control group,serum endostatin decreased significantly after treatment in EECP group,t =-2.277 P = 0.027.Conclusion:External counterpulsation combined with conventional drug treatment can reduce the angina pectoris and improve exercise tolerance in patients with coronary artery disease,and the effect is significantly better than that of conventional drug treatment alone.Enhanced external counterpulsation is an effective method for the treatment of coronary artery disease.Besides,enhanced external counterpulsation can reduce serum endostatin in patients with coronary artery disease,which may be a potential mechanism for clinical efficacy of external counterpulsation. |
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