The improvement of the shear stress and oscillatory shear index of coronary arteries during Enhanced External Counterpulsation in patients with coronary heart disease

Traditional enhanced external counterpulsation (EECP) used for the clinical treatment of patients with coronary heart disease only assesses diastolic/systolic blood pressure (Q = D/S > 1.2). However, improvement of the hemodynamic environment surrounding vascular endothelial cells of coronary arteries after long-term application of EECP is the basis of the treatment. Currently, the quantitative hemodynamic mechanism is not well understood. In this study, a standard 0D/3D geometric multi-scale model of the coronary artery was established to simulate the hemodynamic effects of different counterpulsation modes on the vascular endothelium. In this model, the neural regulation caused by counterpulsation was thoroughly considered. Two clinical trials were carried out to verify the numerical calculation model. The results demonstrated that the increase in counterpulsation pressure amplitude and pressurization duration increased coronary blood perfusion and wall shear stress (WSS) and reduced the oscillatory shear index (OSI) of the vascular wall. However, the impact of pressurization duration was the predominant factor. The results of the standard model and the two real individual models indicated that a long pressurization duration would cause more hemodynamic risk areas by resulting in excessive WSS, which could not be reflected by the change in the Q value. Therefore, long-term pressurization during each cardiac cycle therapy is not recommended for patients with coronary heart disease and clinical treatment should not just pay attention to the change in the Q value. Additional physiological indicators can be used to evaluate the effects of counterpulsation treatment.

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GW27-e0987 Effects of Enhanced External Counterpulsation on Relieving Depression and Anxiety in Patients with Coronary Heart Disease

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2016.07.633 ◽

2016 ◽

Vol 68 (16) ◽

pp. C168

Author(s):

Li Weijie ◽

Wenjuan Zhou ◽

Xiaoling Li ◽

Huanji Zhang ◽

Guifu Wu ◽

...

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Depression And Anxiety ◽

External Counterpulsation ◽

Enhanced External Counterpulsation

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The Effect of Enhanced External Counterpulsation on Platelet Aggregation in Patients with Coronary Heart Disease

Cardiovascular Drugs and Therapy ◽

10.1007/s10557-020-07140-4 ◽

2021 ◽

Author(s):

Yating Wang ◽

Danyan Xu

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Platelet Aggregation ◽

External Counterpulsation ◽

Enhanced External Counterpulsation

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ENHANCED EXTERNAL COUNTERPULSATION EFFECTIVENESS ON CLINICAL PARAMETERS IN DIABETIC AND NON-DIABETIC CORONARY HEART DISEASE PATIENTS

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2018.v11i7.25219 ◽

2018 ◽

Vol 11 (7) ◽

pp. 151

Author(s):

Vikram Singh ◽

Girija Kumari ◽

Bimal Chhajer ◽

Ashok K Jhingan ◽

Saurabh Dahiya

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Blood Sugar ◽

Clinical Symptoms ◽

Glycosylated Hemoglobin ◽

T Test ◽

Drop Out ◽

Significant Drop ◽

External Counterpulsation ◽

Enhanced External Counterpulsation

Objectives: The objectives of the study were to assess the effectiveness of enhanced external counterpulsation (EECP) treatment on clinical profile comprising physiological, biochemical, and clinical symptoms of diabetic and non-diabetic coronary heart disease (CHD) patients.Methods: A pretest–posttest designed prospective study with 163 diabetic and non-diabetic CHD patients enrolled in Science and Art of Living Heart Center (SAAOL), New Delhi, India. Angina severity was assessed using Canadian Cardiovascular Society (CCS) angina classification scale and dyspnea status was assessed using medical research council (MRC) scale. The study subjects were followed up for 12 months. Statistical analysis was done using the SPSS v21 software. Descriptive analysis with sample t-test for two independent groups and paired sample t-test for EECP effectiveness within the group was done.Results: A minute difference in body mass index mean (30.1±5.86–29.9±5.62 vs. 27.5±4.17–27.16±3.88) was observed in diabetic and non-diabetic CHD patients, but that was not statistically significant. A significant drop out in blood sugar fasting (166.7±41.9–150.1±23.7), blood sugar postprandial (204.7±64.4–173.2±41.2), and glycosylated hemoglobin (7.9±0.8 to 7.5±0.6) was also observed in diabetic CHD patients from baseline to 12th month after completion of EECP treatment with significant p<0.001, that may be due to EECP treatment. CCS angina classification score and MRC dyspnea score also significantly improved after EECP treatment.Conclusion: EECP treatment may improve clinical symptoms of CHD and lower the blood glucose level in diabetic CHD patients. This treatment may be effective for CHD patients with diabetes mellitus.

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