心电图触发的骨骼肌刺激可改善心力衰竭患者的血流动力学和身体机能。
ECG-triggered skeletal muscle stimulation improves hemodynamics and physical performance of heart failure patients.
作者信息
Lapanashvili L, Buziashvili Y I, Matskeplishvili S T, Lobjanidze T G, Bockeria L A, Huber P P, Hess O M, Walpoth B H
机构信息
Bakoulev Scientific Center for Cardiovascular Surgery, Moscow, Russia.
出版信息
Int J Artif Organs. 2008 Mar;31(3):244-51. doi: 10.1177/039139880803100308.
BACKGROUND
Muscular counterpulsation (MCP) was developed for circulatory assistance by stimulation of peripheral skeletal muscles. We report on a clinical MCP study in patients with and without chronic heart failure (CHF).
METHODS AND RESULTS
MCP treatment was applied (30 patients treated, 25 controls, all under optimal therapy) for 30 minutes during eight days by an ECG-triggered, battery-powered, portable pulse generator with skin electrodes inducing light contractions of calf and thigh muscles, sequentially stimulated at early diastole. Hemodynamic parameters (ECG, blood pressure and echocardiography) were measured one day before and one day after the treatment period in two groups: Group 1 (9 MCP, 11 no MCP) with ejection fraction (EF) above 40% and Group 2 (21 MCP, 14 no MCP) below 40%. In Group 2 (all patients suffering from CHF) mean EF increased by 21% (p<0.001) and stroke volume by 13% (p<0.001), while end systolic volume decreased by 23% (p<0.001). In Group 1, the increase in EF (6%) and stroke volume (8%) was also significant (p<0.05) but less pronounced than in Group 2. Physical exercise duration and walking distance increased in Group 2 by 56% and 72%, respectively.
CONCLUSIONS
Noninvasive MCP treatment for eight days substantially improves cardiac function and physical performance in patients with CHF.
背景
肌肉反搏（MCP）是通过刺激外周骨骼肌来辅助循环而研发的。我们报告了一项针对有或无慢性心力衰竭（CHF）患者的临床MCP研究。
方法与结果
使用一台由心电图触发、电池供电的便携式脉冲发生器及皮肤电极，在八天内每天对患者进行30分钟的MCP治疗（共治疗30例患者，25例对照，均接受最佳治疗），该发生器可诱导小腿和大腿肌肉进行轻度收缩，并在舒张早期依次刺激。在治疗期前一天和后一天，对两组患者测量血流动力学参数（心电图、血压和超声心动图）：第1组（9例接受MCP治疗，11例未接受）射血分数（EF）高于40%，第2组（21例接受MCP治疗，14例未接受）EF低于40%。在第2组（所有患者均患有CHF）中，平均EF增加了21%（p<0.001），每搏输出量增加了13%（p<0.001），而收缩末期容积减少了23%（p<0.001）。在第1组中，EF（6%）和每搏输出量（8%）的增加也具有显著性（p<0.05），但不如第2组明显。第2组的体育锻炼时长和步行距离分别增加了56%和72%。
结论
对CHF患者进行为期八天的无创MCP治疗可显著改善心脏功能和身体机能。
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