Clinical study on the effect of external counterpulsation on cardiac function and quality of life in patients with median-range ejection fraction complicated with stable coronary heart disease

CHEN Fei; CHEN Wei; GUO Wei-wei; FANG Fang; GAO Xiao-ze; ZHOU Jun

doi:10.3969/j.issn.1672-5301.2024.01.012

Abstract：Objective To investigate the effect of extracorporeal counterpulsation on cardiac function and quality of life in patients with median-range ejection fraction complicated with stable coronary heart disease.Methods A totle of 80 heart failure with mid-range ejection fraction(HFmrEF)patients with stable coronary heart disease admitted to Department of Cardiovascular Medicine,Zhabei Central Hospital,Shanghai from december 2021 to June 2022 were selected as the study objects,and were divided into the control group and external counterpulsation(ECP)group by random number method.The control group was given conventional drug treatment,and the ECP group was combined with external counterpulsation therapy on the basis of conventional drug treatment.Cardiac function indexes,serum NT-proBNP level,6-minute walking distance,quality of life,clinical efficacy,safety indexes and cardiovascular adverse events were recorded and compared between the two groups after 12 months of treatment.Results After 12 months of treatment,left ventricular brachyaxis shortening rate(LVFS)and left ventricular ejection fraction(LVEF)were significantly higher than before treatment(P<0.001)and left ventricular end-diastolic diameter(LVEDD)was significantly lower than before treatment(P<0.001)in both 2 groups.LVFS and LVEF in the ECP group were significantly higher than those in the control group[(28.51±2.83)%vs.(23.69±2.16)%、(46.83±3.67)%vs.(45.27±3.41)%,P<0.05],and LVEDD was significantly lower than that in the control group[(46.69±6.32)%vs.(51.81±6.06)%,P<0.001].The serum level of NT-proBNP in both two groups was significantly lower than before treatment;the walking distance of 6 min in both two groups was significantly longer than before treatment;the level of NT-proBNP in the ECP group was significantly lower than that in the control group[518.45(446.47,784.13)ng/L vs.697.18(542.03,1093.29)ng/L,P<0.05]and the walking distance of 6 min in the ECP group was significantly longer than that in the control group[(441.63±69.15)m vs.(387.26±65.43)m](P<0.001).The MLHFQ score of the two groups was significantly lower than before treatment,and the MLHFQ score of the ECP group was significantly lower than that of the control group(P<0.001).The total effective rate of the ECP group was 97.50%,which was significantly higher than that of the control group 85.90%(P<0.05).The vital signs of the two groups were stable before and after treatment,and the incidence of cardiovascular adverse events in the ECP group was significantly lower than that in the control group(P<0.05).Conclusions ECP can improve the cardiac function,improve the quality of life and reduce the incidence of adverse cardiovascular events in patients with stable coronary heart disease combined with HFmrEF.