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體外反搏治療改善難治性心絞痛患者的收縮壓

EECP Improves Blood Pressure in Patients with Refractory Angina

 

EECP Improves Blood Pressure in Patients with Refractory Angina

BACKGROUND:

Enhanced external counterpulsation (EECP) is a noninvasive treatment of patients with refractory angina. The immediate hemodynamic effects of EECP are similar to intra-aortic balloon pump counterpulsation, but EECP’s effects on standard blood pressure measurements during and after treatment are unknown.

METHODS:

We evaluated systolic blood pressure (SBP) and diastolic blood pressure (DBP) for 108 consecutive patients undergoing EECP. Baseline SBP, DBP, and heart rate were compared for each patient before and after each EECP session, at the end of the course of EECP, and 6 weeks after the final EECP session.

RESULTS:

One hundred eight patients (mean age 66.4 +/- 11.2 years, 81% male) completed 36.5 +/- 5.1 EECP sessions per patient. Overall, based on 3,586 individual readings, EECP resulted in a decrease in mean SBP of 1.1 +/- 15.3 mm Hg at the end of each EECP session (P < .001), 6.4 +/- 18.2 mm Hg at the end the course of EECP (P < .001), and 3.7 +/- 17.8 mm Hg 6 weeks after the final EECP session (P = .07), with no significant change in DBP or heart rate. Stratifying by baseline SBP, a differential response was demonstrated: SBP increased in the 2 lowest strata (<100 mm Hg and 101-110 mm Hg) and decreased in the remaining strata (P < .001). Stratified differences were sustained after individual EECP sessions, at the end of the course of EECP, and 6 weeks after the final EECP session and were independent of changes in cardiovascular medications.

CONCLUSIONS:

Enhanced external counterpulsation improved SBP in patients with refractory angina. On average, EECP decreased SBP during treatment and follow-up; but for patients with low baseline SBP (<110 mm Hg), EECP increased SBP. The improvements in SBP may contribute to the clinical benefit of EECP.

 

「體外反搏治療有效改善難治性心絞痛患者的 收縮壓 」

 背景

體外反搏治療(EECP)是一種非侵入性治療方法,用於治療難治性心絞痛患者。EECP的即時血液動力學效應與主動脈內氣球幫浦反搏類似,但EECP對治療過程中和治療後的標準血壓測量的影響尚不清楚。

方法

我們評估了108名接受EECP治療的連續患者的 收縮壓 和舒張壓。對於每位患者,在每次EECP療程前後、EECP療程結束時以及最後一次EECP療程後的6週,比較了基線 收縮壓 、舒張壓和心率。

結果

共有108名患者完成了36.5次的EECP療程。總體而言,根據3586個單獨的讀數,每次EECP療程結束時平均 收縮壓 下降了1.1毫米汞,EECP療程結束時下降了6.4毫米汞柱,最後一次EECP療程後的6週下降了3.7毫米汞柱,舒張壓和心率沒有顯著變化。根據基線 收縮壓 的分層分析,顯示出不同的反應:在最低的兩個分層中 收縮壓 增加,而在其餘分層中下降。分層差異在個別EECP療程後、EECP療程結束時以及最後一次EECP療程後的6週持續存在,並且與心血管藥物的變化無關。

結論

體外反搏治療改善了難治性心絞痛患者的 收縮壓 。平均而言,在治療和隨訪過程中,EECP會降低 收縮壓 ;但對於基線 收縮壓 較低的患者,EECP會增加 收縮壓 。 收縮壓 的改善可能有助於EECP的臨床效益。

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