| BackgroundEnhanced external counter pulsation(enhanced external counter pulsation,EECP)by means of the sequential type pressure of lower limbs,will drive blood flow back to the heart,increases diastolic blood perfusion of important organs such as heart and brain,and promotes coronary collateral circulation,improve myocardial ischemia.The double pulsed blood flow mode of EECP can improve blood flow shear stress,protect vascular endothelium,reduce inflammatory factors and adhesion factors in plasma,inhibit the proinflammatory response of cardiovascular diseases,and delay the progression of atherosclerosis.With the development of social economy and medical technology,China has entered an aging society,and coronary heart disease is one of the main causes of death among the elderly.EECP is a non-invasive cardiac rehabilitation therapy that can effectively prevent coronary heart disease.ObjectiveThis study was designed to investigate the efficacy and safety of EECP in elderly patients(?80 years)with chronic stable coronary heart disease.MethodA prospective study was consecutive conducted in 336 patients with chronic stable coronary heart disease aged 60 years or older who were treated in Henan Provincial Hospital from May 2016 to October 2017.According to age and treatment method,they were divided into the elderly EECP group 84 cases(?80 years old),the elderly control group 84 cases,old EECP group 168 cases(60 years old ? age <80 years old).The control group received anti-platelet drugs,Angiotensin converting enzyme inhibitors/Angiotensin Receptor Blocker,?-blockers,calcium antagonists,nitrates,statins.EECP group were given 1 course of treatment EECP treatment(0.5h / time,2 times / day,36 days / course of treatment)besides from conventional therapy.To observe the changes of the control group and the EECP group after a course of treatment(Seattle angina questionnaire,SAQ;Pittsburgh sleep quality index,PSQI),and the incidence of major cardiovascular events and rehospitalization rates.ResultAfter one course of treatment,In the elderly EECP group,the score of physical activity limitation was 35.62±10.66,the score of anginal stability was 53.21±22.89,the score of anginal frequency was 39.64 ± 16.53,the score of treatment satisfaction was 37.92±5.95;the score of subjective sleep quality was 1.02±0.69,the score of sleep latency was1.25±0.64,the score of sleep duration was0.93±0.62,the score of habitual sleep efficiency was1.12±0.62,the score of sleep disturbances was1.18±0.44,the score of use of sleeping medication was 1.20±0.62,and the score of daytime dysfunction was1.33±0.47.The SAQ and PSQI in the elderly EECP group were significantly better than those in the control group(P <0.01).The incidence of major cardiovascular events in the elderly EECP group was 31.0%(26/84),which was lower than that in the control group,66.7%(56/84),statistically significant(P<0.05).There were no significant differences in the incidence of major cardiovascular events and rehospitalization between the elderly EECP group and the old EECP group in 1,3,6,12 months,(P> 0.05).ConclusionFor elderly patients with chronic stable coronary heart disease,EECP is relatively safe and effective.As a non-invasive cardiac rehabilitation therapy method,it is worthy of popularization and application in primary medical institutions. |
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