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EECP 对缺血性心力衰竭的影响:系统评价。

The Effect of EECP on Ischemic Heart Failure: a Systematic Review.

机构信息

Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, Beijing, 100191, China.

State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University, Beijing, 100191, China.

出版信息

Curr Cardiol Rep. 2023 Oct;25(10):1291-1298. doi: 10.1007/s11886-023-01943-1. Epub 2023 Aug 29.

Abstract

PURPOSE OF REVIEW

Heart failure is a serious global health problem, and coronary artery disease is one of the main causes. At present, the treatment options for ischemic heart failure (IHF) are limited. This article mainly aims to explore the evidence of enhanced external counterpulsation (EECP) as a non-invasive cardiac rehabilitation method in patients with IHF and to make a preliminary exploration of its mechanisms.

RECENT FINDINGS

According to the existing evidence, the standard course of EECP is safe in patients with IHF and can significantly improve the quality of life of these patients. The effect of EECP on systolic function is still unclear, while EECP has a significant improvement effect on cardiac diastolic function. At the same time, this treatment can reduce the re-hospitalization rate and emergency visit rate of patients within 6 months. In terms of mechanisms, in addition to the immediate hemodynamic effect, existing evidence mostly suggests that its improvement of cardiac function may come from its upregulation of shear stress to improve myocardial perfusion. EECP is safe to use in patients with stable ischemic heart failure, and it can improve the performance status of patients and may be beneficial to cardiac function and reduce the short-term re-hospitalization rate.

摘要

目的综述

心力衰竭是一个严重的全球健康问题,而冠状动脉疾病是其主要病因之一。目前,缺血性心力衰竭(IHF)的治疗选择有限。本文主要旨在探讨增强型体外反搏(EECP)作为一种非侵入性心脏康复方法在 IHF 患者中的应用证据,并对其机制进行初步探索。

最新发现

根据现有证据,EECP 标准疗程在 IHF 患者中是安全的,可显著改善这些患者的生活质量。EECP 对收缩功能的影响尚不清楚,而 EECP 对心脏舒张功能有显著改善作用。同时,这种治疗可以降低患者 6 个月内的再住院率和急诊就诊率。在机制方面,除了即时血流动力学效应外,现有证据大多表明,其改善心功能可能来自于对剪切力的上调,从而改善心肌灌注。EECP 对稳定型缺血性心力衰竭患者使用安全,可改善患者的活动状态,可能有益于心功能并降低短期再住院率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ded6/10651544/aee10d74cb47/11886_2023_1943_Fig1_HTML.jpg

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