Zhang Yahui, Zhang Yujia, Wang Yinfen, Xu Xiuli, Jin Jing, Zhang Xiaodong, Zhang Wei, Wei Wenbin, Zhong Chubin, Wu Guifu
Department of Cardiology, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, China.
NHC Key Laboratory of Assisted Circulation, Sun Yat-sen University, Guangzhou, China.
Front Cardiovasc Med. 2021 Dec 24;8:795697. doi: 10.3389/fcvm.2021.795697. eCollection 2021.
This study aimed to investigate acute hemodynamics of lower extremities during enhanced external counterpulsation with a three-level sequence at the hips, thighs, and calves (EECP-3), two-level sequence at the hips and thighs (EECP-2), and single leg three-level sequence (EECP-1). Twenty healthy volunteers were recruited in this study to receive a 45-min EECP intervention. Blood flow spectrums in the anterior tibial artery, posterior tibial artery, and dorsalis pedis artery were imaged by Color Doppler ultrasound. Mean flow rate (FR), area, pulsatility index (PI), peak systolic velocity (PSV), end-diastolic velocity (EDV), mean flow velocity (MV), and systolic maximum acceleration (CCAs) were sequentially measured and calculated at baseline during EECP-3, EECP-1, and EECP-2. During EECP-3, PI, PSV, and MV in the anterior tibial artery were significantly higher, while EDV was markedly lower during EECP-1, EECP-2, and baseline (all < 0.05). Additionally, ACCs were significantly elevated during EECP-3 compared with baseline. Moreover, FR in the anterior tibial artery was significantly increased during EECP-3 compared with baseline ( = 0.048). During EECP-2, PI and MV in the dorsalis pedis artery were significantly higher and lower than those at baseline, (both < 0.05). In addition, FR was markedly reduced during EECP-2 compared with baseline ( = 0.028). During EECP-1, the area was significantly lower, while EDV was markedly higher in the posterior tibial artery than during EECP-1, EECP-2, and baseline (all < 0.05). Meanwhile, FR of the posterior tibial artery was significantly reduced compared with baseline ( = 0.014). Enhanced external counterpulsation with three-level sequence (EECP-3), EECP-2, and EECP-1 induced different hemodynamic responses in the anterior tibial artery, dorsalis pedis artery, and posterior tibial artery, respectively. EECP-3 acutely improved the blood flow, blood flow velocity, and ACCs of the anterior tibial artery. In addition, EECP-1 and EECP-2 significantly increased the blood flow velocity and peripheral resistance of the inferior knee artery, whereas they markedly reduced blood flow in the posterior tibial artery.
本研究旨在探讨在髋部、大腿和小腿采用三级序列（EECP - 3）、髋部和大腿采用两级序列（EECP - 2）以及单腿三级序列（EECP - 1）进行增强型体外反搏期间下肢的急性血流动力学变化。本研究招募了20名健康志愿者，接受45分钟的增强型体外反搏干预。通过彩色多普勒超声对胫前动脉、胫后动脉和足背动脉的血流频谱进行成像。在EECP - 3、EECP - 1和EECP - 2期间，于基线时依次测量并计算平均流速（FR）、面积、搏动指数（PI）、收缩期峰值流速（PSV）、舒张末期流速（EDV）、平均流速（MV）和收缩期最大加速度（CCAs）。在EECP - 3期间，胫前动脉的PI、PSV和MV显著更高，而在EECP - 1、EECP - 2和基线期间EDV显著更低（均P < 0.05）。此外,与基线相比，EECP - 3期间ACCs显著升高。而且，与基线相比，EECP - 3期间胫前动脉的FR显著增加（P = 0.048）。在EECP -2期间，足背动脉的PI和MV显著高于和低于基线水平（均P < 0.05）。此外，与基线相比，EECP - 2期间FR显著降低（P = 0.028）。在EECP - 1期间，胫后动脉的面积显著更低，而EDV显著高于EECP - 1、EECP - 2和基线期间（均P < 0.05）。同时，与基线相比，胫后动脉的FR显著降低（P = 0.014）。采用三级序列（EECP - 3）、EECP - 2和EECP - 1进行增强型体外反搏分别在胫前动脉、足背动脉和胫后动脉诱导了不同的血流动力学反应。EECP - 3急性改善了胫前动脉的血流、血流速度和ACCs。此外，EECP - 1和EECP - 2显著增加了膝下动脉的血流速度和外周阻力，而它们显著降低了胫后动脉的血流。
