增强型体外反搏治疗对老年射血分数保留心力衰竭患者的疗效

目的:探讨增强型体外反搏(EECP)治疗老年左心室射血分数保留的心力衰竭(HFpEF)患者的作用和血流动力学效应。方法:回顾性分析2018年1月至2019年12月在山东大学齐鲁医院体外反搏中心登记治疗的66例老年HFpEF患者的临床资料。主要观察指标为6 min步行距离试验，次要指标为明尼苏达心力衰竭生活质量调查表(M...

The effect of enhanced external counterpulsation on heart failure with preserved ejection fraction in the elderly

Objective To investigate the effect of enhanced external counterpulsation(EECP)on heart failure with preserved ejection fraction(HFpEF)and hemodynamics in elderly patients.Methods Clinical data of 66 elderly HFpEF patients admitted to the enhanced external counterpulsation center of our hospital from January 2018 to December 2019 were retrospectively analyzed.The primary assessment parameter was the six-minute walk distance,and the secondary parameters included the Minnesota Living with Heart Failure Questionnaire(MLHFQ).Noninvasive hemodynamic parameters including the cardiac index(CI),stroke volume(SV),isovolumic relaxation period(A2-mitral valve opening,A2-O),pulmonary capillary wedge pressure(PCWP)and total peripheral resistance(TPR)were monitored and mean arterial blood pressure(MAP)was calculated.Results After EECP treatment,the six-minute walk distance increased(372±87 m vs.341±85 m,P<0.05),the score of MLHFQ decreased(47.0±16.0 vs.50.0±17.0,P<0.05),CI increased(2.8±0.7)L·min^-1·m^-2vs.(2.6±0.6)L·min^-1·m^-2(P<0.05),SV,PCWP and A2-O did not show significant change(73.3±16.4 ml vs.71.5±17.1 ml,10.0±3.3 mmHg vs.11.0±3.6 mmHg,1 mmHg=0.133 kPa,98.0±29.5 ms vs.91.0±29.1 ms,P>0.05),TPR decreased(1719.0±427.0 DS/cm⁵vs.1821.0±508.0 DS/cm⁵,P<0.05),and there was no significant change in MAP(96.9±10.7 mmHg vs.98.8±13.1 mmHg,P>0.05),compared with pre-EECP treatment levels.Compared with patients without hypertension,MAP decreased in patients with hypertension(14 cases),when stratified by the initial MAP(P<0.05).Conclusions For elderly patients with HFpEF,EECP can increase the six-minute walk distance,improve the quality of life and hemodynamic parameters,and is a safe adjuvant treatment.