Mechanism of external counterpulsation in treatment of ischemic cardiomyopathy heart failure with atrial fibrillation

WU Zhi-bin; SHAO Hui-zhen; WANG Zhong-liang

doi:10.3969/j.issn.1672-5301.2025.05.008

Abstract：Objective To study the improvement effect of external counterpulsation therapy on cardiac function in patients with ischemic cardiomyopathy heart failure complicated with atrial fibrillation(AF).Methods The total effective rate of the study group was significantly increased with the control group(95.96％vs.87.88％).After 4 weeks of treatment,the left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD)and myocardial energy metabolism level(MEE)of the two groups were significantly decreased,the left ventricular ejection fraction(LVEF),cardiac output(CO)and stroke volume(SV)were significantly increased,and the LVEDD and LVESD and MEE were lower than those in the control group,LVEF,CO,SV were higher than those in the control group.NT-proBNP,sst2,cardiac troponin(cTnI),creatine kinase isoenzyme(CK),myocardial creatine kinase(CK-MB)in the two groups were significantly decreased,and NT-proBNP[(385.09±99.18)ng/ml vs.(552.35±102.41)ng/ml],SST2[(12.78±1.35)ng/ml vs.(26.98±1.25)ng/ml],CTNI[(0.02±0.01)ng/ml vs.(0.05±0.02)ng/ml],CK[(79.51±11.28)U/ml vs.(87.36±11.15)U/ml],CK-MB[(19.52±1.14)U/ml vs.(22.95±1.22)U/ml]in the two groups were significantly lower than those in the control group.The mean standard deviation of RR interval(SDANN),the standard deviation of RR interval of 24 h sinus beats(SDNN)and the square mean difference of adjacent normal RR interval(RMSSD)were significantly increased,and the total myocardial ischemic load of the study group[(248.28±14.32)mm/min vs.(310.28±10.17)mm/min]was lower than that of the control group,SDANN[(131.68±17.19)vs.(116.06±11.38)],RMSSD[(41.84±1.38)vs.(31.53±1.29)],SDNN(t=191.988,P=0.the total cholesterol(TC),triglyceride(TG),creatinine(SCR),urea nitrogen(BUN),urinary albumin excretion rate(UAER),C-reactive protein(CRP),prostaglandin E2(PGE2)of the two groups were significantly decreased,while high-density lipoprotein cholesterol(HDL-C)was significantly increased,and the above indicators of the study group were lower than those of the control group except HDL-C.The incidence of atrial fibrillation(6.06％vs.15.15％),high burden of atrial fibrillation(7.07％vs.17.17％)and acute heart failure(9.09％vs.21.21％)in the study group were lower than those in the control group.Conclusion In patients with ischemic cardiomyopathy heart failure complicated with atrial fibrillation,external counterpulsation therapy can effectively regulate NT-proBNP,sST2 and myocardial enzyme spectrum,optimize inflammatory indicators,blood lipid levels and renal function,improve the cardiac function and total myocardial load of patients,and the therapeutic effect is remarkable.