Effect of Enhanced external counterpulsation Machines

by Ms.Mona Z. EECP machines Manufacturer

Definition of coronary atherosclerotic heart disease

Coronary atherosclerotic heart disease (CHD) is an epidemic disease in western developed countries. With the changes in the dietary habits and age structure of Chinese residents, coronary heart disease is also a high-risk trend in the elderly in China. Atherosclerosis of blood vessels begins in childhood and gradually develops, usually in middle and old age due to coronary artery spasm, stenosis or occlusion, causing myocardial ischemia and hypoxia until myocardial cell death, resulting in damage to heart function.

Treatment problems

At present, for acute myocardial infarction, drug thrombolysis and percutaneous coronary intervention (PCI) are still the main clinical treatment options, especially left coronary artery lesions or three branch lesions also require coronary surgery for coronary surgery Arterial bypass grafting (CABG). Revascularization can quickly restore coronary blood flow, partially restore the normal function of injured myocardium, and significantly improve the prognosis of patients with acute myocardial infarction. However, it is clinically found that patients undergoing cardiac coronary revascularization have poor recovery due to various reasons after surgery, which greatly affects the patient's activity tolerance and quality of life. Therefore, the patient's activity tolerance after blood revascularization is reduced, and the quality of life is reduced, which has become a problem that clinicians need to overcome.

Enhanced external counterpulsation Machines

External counterpulsation is a non-invasive extracorporeal circulation device. It was originally used to restore peripheral circulation of cardiogenic shock, and is currently mainly used for ischemic treatment of cardiovascular and cerebrovascular diseases. Since the invention of external counterpulsation technology, after continuous clinical research and practice of cardiovascular experts, its therapeutic effect and safety have been recognized internationally. According to the 2013 European Guidelines for the Treatment of Coronary Heart Disease, EECP treatment can still be recommended after medical treatment and revascularization (including PCI / CABG). Therefore, this study intends to confirm once again the efficacy of EECP in patients with coronary heart disease who have undergone revascularization.

Enhanced external counterpulsation therapy by noninvasive compression of the patient's limbs and buttocks, inflation and compression during the diastolic period, which promotes the blood flow of the lower body to the aorta, thereby increasing the diastolic blood flow and improving myocardial ischemia and hypoxia In the state, and quickly exhaust during the systole, relieve the pressure, reduce the resistance of the heart to ejection, and the blood flows quickly to the far end. Studies have confirmed that EECP can also improve blood flow shear stress, inhibit oxidative stress and inflammatory response, improve endothelial cell function, establish coronary collateral circulation, improve the contractility of coronary vessels, promote the recovery of its vascular elasticity and improve its Prognosis.

Research on EECP treatment at home and abroad, including earlier prospective randomized double-blind multi-center EECP (MUST-EECP) study, EECP treatment of coronary artery disease (RECC), International EECP Patient Registration Center (IEPR) and other registration studies Most of the selected cases have undergone PCI / CABG, and about half of the patients have a history of myocardial infarction, combined with cardiac insufficiency, diabetes, etc. Conventional drugs or blank control groups support EECP treatment to safely and effectively reduce CCS in patients after PCI. Classification, improve exercise tolerance, improve heart function, and reduce the occurrence of major cardiovascular adverse events. This study is consistent with the results of this trial. Patients in the EECP group showed a significant improvement in walking distance after treatment at six minutes after treatment, and more significant improvement than the control group. 6MWT is simple and easy, not limited by hospital level and technical difficulty. The exercise intensity is close to the daily activities of the human body, which has a certain role in evaluating the patient's exercise tolerance. A large number of clinical trials have confirmed that elderly patients with coronary heart disease after PCI / CABG, including patients with complications such as myocardial infarction, cardiac insufficiency, diabetes, angina pectoris, and revascularization can no longer choose vascular recanalization treatment, can be treated from EECP Benefit. Sun Gang and other studies suggest that EECP can improve the postoperative slow blood flow phenomenon and cardiac function in patients with acute ST-segment elevation myocardial infarction (STEMI) in the short term. The mechanism may be related to improving the patient's hemodynamics. Serum enzymes in patients with SETMI have no obvious effect and are a safe and effective treatment. Tan Yongjin and other studies found that the microcirculation resistance index of patients in the EECP group was significantly lower than the immediate postoperative level and the control group (P <0.05), indicating that EECP treatment can reduce myocardial microcirculation resistance and improve myocardial microcirculation in patients with coronary heart disease stent implantation. cycle.

Compared with drug treatment alone, after EECP treatment, the scores of the 8 dimensions of the patient's physiological function, physiological function, physical pain, general health status, energy, social function, emotional function and mental health were significantly higher than before. Some studies suggest that cardiac rehabilitation after CABG can help patients establish a correct understanding of the disease, adjust possible anxiety, depression and other negative emotions, thereby improving the patient's psychological state and enhancing the patient's willingness and confidence to return to society. Yao Xiaohua and others proposed that EECP treatment can not only improve the heart function of patients, but also have a significant effect on improving the skeletal muscle function of elderly patients. During EECP treatment, the limb blood vessels are compressed and relaxed by EECP continuous inflation and deflation, which increases the pressure difference of the blood vessels and increases the blood flow rate and flow, resulting in increased opening of the collateral and anastomotic branches of the lower extremity blood vessels, quickly improving the blood circulation of the lower extremities, and improving the peripheral The ability of skeletal muscle to take in oxygen. At the same time, along with the improvement of microcirculation, the density and number of muscle capillaries increase, and the exercise muscle group's ability to use oxygen and metabolic capacity increase, which improves the patient's exercise endurance and reduces fatigue.

Treatment Period

The current standard EECP treatment plan still lacks sufficient evidence-based medicine. Some research results show that 36 1h courses (6d, 1h / d for 6 weeks), or 35h courses (5d, 1h / d for 7 weeks) are effective, this program can penetrate the heart Stages I, II, and III of rehabilitation management. Although a large number of studies recommend standard and foot treatment, but in clinical practice observation, patients can still benefit even if they shorten the treatment time. For patients with frequent angina attacks after revascularization, the treatment time should be appropriately extended, or repeated treatment for a long time. There is no doubt about safety, and its effectiveness needs further observation.

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