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Research ArticleOriginal Article
Open Access

Enhanced external counterpulsation increases coronary flow reserve in coronary microvascular disease

Qian Wang, Jia Hao, Wenjun Jiang and Qiang Tan
Saudi Medical Journal December 2023, 44 (12) 1277-1282; DOI: https://doi.org/10.15537/smj.2023.44.12.20230427
Qian Wang
From the Department of Cardiology, The first hospital of Qinhuangdao, Hebei Medical University, Qinhuangdao, Hebei, China.
MD
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Jia Hao
From the Department of Cardiology, The first hospital of Qinhuangdao, Hebei Medical University, Qinhuangdao, Hebei, China.
MD
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Wenjun Jiang
From the Department of Cardiology, The first hospital of Qinhuangdao, Hebei Medical University, Qinhuangdao, Hebei, China.
MD
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Qiang Tan
From the Department of Cardiology, The first hospital of Qinhuangdao, Hebei Medical University, Qinhuangdao, Hebei, China.
MD, PhD
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  • ORCID record for Qiang Tan
  • For correspondence: [email protected]
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Article Figures & Data

Figures

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  • Figure 1
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    Figure 1

    - Coronary flow reserve (CFR) improvement after 4 weeks of enhanced external counterpulsation (EECP). *P<0.05 relative to control, #p<0.05 relative to baseline

  • Figure 2
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    Figure 2

    - Changes of endothelial nitric oxide synthase (eNOS) after 4 weeks enhanced external counterpulsation (EECP). *P<0.05 relative to control, #p<0.05 relative to baseline

  • Figure 3
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    Figure 3

    - Changes of endothelin-1 (ET-1) after 4 weeks enhanced external counterpulsation (EECP). *P<0.05 relative to control, #p<0.05 relative to baseline

  • Figure 4
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    Figure 4

    - Changes of Canadian Cardiovascular Society (CCS) angina class after 4 weeks enhanced external counterpulsation (EECP). *P<0.05 relative to control, #p<0.05 relative to baseline

Tables

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    Table 1

    - Evaluation of the clinicopathological profiles of control and EECP treated cohorts.

    ParametersEECP group (n=41)Control group (n=42)P-value
    Age (years)60.85 ± 8.4459.52 ± 8.670.481
    Gender (male/female)20/2117/250.447
    Hypertension25/4125/420.893
    Diabetes10/417/420.383
    Smoker10/4111/410.850
    SBP (mmHg)
    baseline135.90 ± 17.87133.26 ± 16.430.485
    4 weeks137.76 ± 11.45135.33 ± 12.810.415
    DBP (mmHg)
    baseline78.98± 12.2582.76 ± 11.940.158
    4 weeks79.86 ± 12.9780.04 ± 10.990.434
    TC (mmol/L)
    baseline4.28 ± 0.964.32± 1.120.380
    4 weeks4.31 ± 0.724.27 ± 0.790.361
    TG (mmol/L)
    baseline1.83 ± 1.082.07 ± 1.220.167
    4 weeks1.76 ± 0.661.93 ± 0.760.214
    LDL-C (mmol/L)
    baseline2.32 ± 0.752.36 ± 0.780.179
    4 weeks2.33 ± 0.812.31 ± 0.930.256
    HDL-C (mmol/L)
    baseline1.10 ± 0.300.96± 0.220.135
    4 weeks1.12 ± 0.261.04 ± 0.310.178
    FBS (mmol/L)
    baseline5.52 ± 0.795.88 ± 1.230.136
    4 weeks5.45 ± 1.675.67± 1.330.247
    Body mass index
    baseline25.82 ± 2.8626.59 ± 2.680.213
    4 weeks25.67 ± 2.7126.54 ± 2.300.315
    LVD (mm)
    baseline48.05 ± 3.5948.51 ± 5.340.646
    4 weeks47.89 ± 4.3048.65 ± 5.670.357
    LAD (mm)
    baseline36.49 ± 3.7637.90 ± 5.240.165
    4 weeks37.01 ± 3.7837.44 ± 5.610.412
    LVEF (%)
    baseline67.81 ±5.1565.26 ± 6.870.127
    4 weeks66.35 ± 7.2466.02± 7.300.348

    EECP: enhanced external counterpulsation, SBP: systolic blood pressure, DBP: diastolic blood pressure, TC: cholesterol, TG: triglyceride, LDL-C: low-density lipoprotein cholesterol, HDL-C: high-density lipoprotein cholesterol, FBS: fasting blood glucose

      • View popup
      Table 2

      - Quality of life (QoL) evaluated by Seattle Angina Questionnaire score.

      EECP group (n=41)Control group (n=42)P-value
      Physical limitation
      baseline34.34 ± 6.8433.71 ± 6.710.674
      4 weeks42.65 ± 7.24*†35.59 ± 7.610.000
      Angina stability
      baseline32.85 ± 6.6133.61 ± 6.080.585
      4 weeks43.90 ± 6.34*†36.35 ± 5.77†0.000
      Angina frequency
      baseline37.17 ± 5.6737.59 ± 5.990.741
      4 weeks47.53 ± 6.51*†42.01 ± 5.29†0.000
      Treatment satisfaction
      baseline43.95 ± 6.5744.19 ± 7.050.873
      4 weeks55.43 ± 6.81*†48.78 ± 8.38†0.000
      Disease perception
      baseline29.73 ± 4.8428.47 ± 6.420.319
      4 weeks43.39 ± 5.94*†32.76 ± 6.73†0.000

      EECP: enhanced external counterpulsation

      • ↵* P<0.05 compared with control,

      • ↵† P<0.05 compared with baseline.

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    Enhanced external counterpulsation increases coronary flow reserve in coronary microvascular disease
    Qian Wang, Jia Hao, Wenjun Jiang, Qiang Tan
    Saudi Medical Journal Dec 2023, 44 (12) 1277-1282; DOI: 10.15537/smj.2023.44.12.20230427

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    Enhanced external counterpulsation increases coronary flow reserve in coronary microvascular disease
    Qian Wang, Jia Hao, Wenjun Jiang, Qiang Tan
    Saudi Medical Journal Dec 2023, 44 (12) 1277-1282; DOI: 10.15537/smj.2023.44.12.20230427
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    Keywords

    • enhanced external counterpulsation
    • coronary flow reserve
    • coronary microvascular disease
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