Effect Of Enhanced External Counterpulsation On Activity Tolerance Of Patients With Coronary Heart Disease With Cardiac Insufficiency:Meta Analysis

Objective : To explore the effect of enhanced external counterpulsation(EECP)on the activity tolerance of patients with coronary heart disease and cardiac insufficiency by using the method of Meta analysis.Methods: We search China National Knowledge Infrastructure(CNKI),VIP database,Wanfang database,Pub Med,Cochrane Library,EMBASE,Springer Link and Web of Science.We have collected relevant studies on enhanced external counterpulsation treatment of patients with coronary heart disease and cardiac insufficiency from the establishment of the database to March 2021.First,according to the inclusion and exclusion criteria,select suitable studies.Second,extract the data in the research,evaluate the methodological quality of the research,and then use the Rev Man5.3 software for statistical analysis.The main observation indicators are 6-minute walk test(6WMT)and peak oxygen consumption(VO2peak),and the secondary observation indicators are N-terminal brain natriuretic peptide(NT-pro BNP)and left ventricular ejection fraction(LVEF).Results: In the end,11 studies were included in this meta-analysis,including 1067 cases.The experimental group received EECP treatment on the premise of drug treatment,while the control group only received drug treatment.Compared with the curative effect of the drug treatment group only,the EECP combined drug treatment group has better curative effect.After the analysis,the result is:VO2peak(MD=2.63,95%CI: 1.54-3.72,P < 0.00001),6WMT(MD=62.75,95%CI: 51.01-74.49,P <.00001),NT-pro BNP(MD=-235.28,95%CI:-365.67-104.89,P<0.00001),LVEF(MD=7.97,95%CI: 4.27-11.66,P<0.00001).Conclusion: Compared with the control group that did not receive enhanced external counterpulsation,enhanced external counterpulsation can increase the6-minute walking distance of patients with coronary heart disease and cardiac insufficiency,increase their peak oxygen uptake,increase their left ventricular ejection fraction,and reduce their NT-pro BNP.During the treatmen,The probability of occurrence of adverse events is low,and the probability of occurrence of death events is low.The results show that enhanced external counterpulsation can be used as a safe and effective cardiac rehabilitation method for patients with coronary heart disease and cardiac insufficiency on the basis of standardized treatment.Nevertheless,due to the special intervention methods,not all of the included literature is blinded,the selected studies are of low quality,and their quality evaluation grades are all B.The selected studies have different levels of bias,they did not evaluate the long-term efficacy.In the future,it is necessary to conduct larger and more scientific randomized controlled studies to explore the efficacy of enhanced external counterpulsation in patients with coronary heart disease and cardiac insufficiency.