Liu Yanqiu, Xiong Yan, Liu Donghong, Luo Chufan, Zhang Yan, Wu Guifu, Xie Qiang, Dong Yugang, Zheng Zhensheng
Division of Ultrasound, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Clin Physiol Funct Imaging. 2012 Jul;32(4):262-7. doi: 10.1111/j.1475-097X.2012.01120.x. Epub 2012 Jan 26.
Lipid disorder causes vascular endothelial cell damage and contributes to the early development of dyslipidaemia-induced atherosclerosis. In vivo and in vitro, it has been found that increasing shear stress can improve endothelial function. Clinically, enhanced external counterpulsation (EECP) plays important roles in the treatment of coronary artery disease by promoting arterial shear stress. The present study aims to evaluate the effect of EECP on vascular endothelial function in porcine hypercholesterolaemic model.
Twenty-six hypercholesterolaemic pigs were equally divided into EECP group (HC-EECP group) and control group (HC group). Shear stress of a right forearm superficial artery was measured during EECP in comparison with the basal physiological status in the HC-EECP group. Endothelial-dependent flow-mediated vasodilation (FMD) was applied to assess endothelial function. Serum high-sensitivity C-reactive protein (hs-CRP) levels were measured at indicated time points.
Endothelial shear stress was increased significantly during EECP treatment (P<0.001). Compared to HC group, hs-CRP decreased significantly by EECP at 18- and 36-h, respectively (P<0.05). FMD was improved significantly by EECP compared to that of HC group at 18 h (11.09 ± 5.63%) and at 36 h (11.42 ± 2.75%) post-EECP, P<0.05. Meanwhile, in animals of HC group, FMD was decreased from baseline 7.76 ± 3.70% to 6.75 ± 3.57% at 18 h and 5.07 ± 1.97% at 36 h, P<0.05.
Long-term EECP can improve endothelial function partially by an increased endothelial shear stress in hypercholesterolaemic porcine model. This implies that long-term EECP can be used as a complementary therapeutic strategy to prevent atherosclerosis in hypercholesterolaemic patients.
脂质紊乱会导致血管内皮细胞损伤，并促使血脂异常诱发的动脉粥样硬化早期发展。在体内和体外研究中均发现，增加剪切应力可改善内皮功能。临床上，增强型体外反搏（EECP）通过促进动脉剪切应力，在冠状动脉疾病治疗中发挥重要作用。本研究旨在评估EECP对猪高胆固醇血症模型血管内皮功能的影响。
将26只高胆固醇血症猪平均分为EECP组（HC-EECP组）和对照组（HC组）。在EECP过程中，测量右侧前臂浅表动脉的剪切应力，并与HC-EECP组的基础生理状态进行比较。采用内皮依赖性血流介导的血管舒张功能（FMD）评估内皮功能。在指定时间点测量血清高敏C反应蛋白（hs-CRP）水平。
EECP治疗期间，内皮剪切应力显著增加（P<0.001）。与HC组相比，EECP分别在18小时和36小时时使hs-CRP显著降低（P<0.05）。与HC组相比，EECP在EECP后18小时（11.09±5.63%）和36小时（11.42±2.75%）时显著改善了FMD，P<0.05。同时，在HC组动物中，FMD从基线时的7.76±3.70%在18小时时降至6.75±3.57%，在36小时时降至5.07±1.97%，P<0.05。
在高胆固醇血症猪模型中，长期EECP可通过增加内皮剪切应力部分改善内皮功能。这表明长期EECP可作为一种辅助治疗策略，用于预防高胆固醇血症患者的动脉粥样硬化。
