Key result
Enhanced external counterpulsation significantly reduced the physiological coupling between respiratory and cardiovascular systems (PSI_RES-PTT 0.34 vs 0.49 at baseline, P=0.002) immediately after intervention in healthy adults.
Why the study?
EECP has complex physiological and hemodynamic effects, but its impact on the coupling of integrated physiological systems remains unclear.
Does enhanced external counterpulsation alter physiological coupling in healthy adults?
RCT (n=41)
Sham-controlled
Simple computer-generated sequence
No
Does enhanced external counterpulsation alter physiological coupling in healthy adults?
Absolute Event Rate: 0.34% vs 0.49%
p-value: p=0.002
Enhanced external counterpulsation immediately reduces physiological coupling between cardiorespiratory and cardiovascular systems in healthy adults, providing a potential marker for exploring its mechanism of action.
EECP acutely reduces cardiorespiratory coupling post-session in healthy adults; hypothesis-generating for mechanisms, needs confirmation in patients.
Introduction Enhanced external counterpulsation (EECP) is a non-invasive assisted circulation technique for its clinical application in the rehabilitation and management of ischemic cardiovascular and cerebrovascular diseases, which has complex physiological and hemodynamic effects. However, the effects of EECP on the coupling of physiological systems are still unclear. We aimed to investigate the immediate effects of EECP on the coupling between integrated physiological systems such as cardiorespiratory and cardiovascular systems. Methods Based on a random sham-controlled design, simultaneous electrocardiography, photoplethysmography, bio-electrical impedance, and continuous hemodynamic data were recorded before, during and after two consecutive 30 min EECP in 41 healthy adults. Physiological coupling strength quantified by phase synchronization indexes (PSI), hemodynamic measurements and heart rate variability indices of 22 subjects (female/male: 10/12; age: 22.6 ± 2.1 years) receiving active EECP were calculated and compared with those of 19 sham control subjects (female/male: 7/12; age: 23.6 ± 2.5 years). Results Immediately after the two consecutive EECP interventions, the physiological coupling between respiratory and cardiovascular systems PSIRES–PTT (0.34 ± 0.14 vs. 0.49 ± 0.17, P = 0.002), the physiological coupling between cardiac and cardiovascular systems PSIIBI–PTT (0.41 ± 0.14 vs. 0.52 ± 0.16, P = 0.006) and the total physiological coupling PSItotal (1.21 ± 0.35 vs. 1.57 ± 0.49, P = 0.005) in the EECP group were significantly lower than those before the EECP intervention, while the physiological coupling indexes in the control group did not change significantly (P > 0.05). Conclusion Our study provides evidence that the PSI is altered by immediate EECP intervention. We speculate that the reduced PSI induced by EECP may be a marker of disturbed physiological coupling. This study provides a new method for exploring the mechanism of EECP action and may help to further optimize the EECP technique.
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Liu et al. (2023) conducted an RCT in Healthy (n=41). Enhanced external counterpulsation (EECP) vs. Sham EECP (0 Mpa) was evaluated on Physiological coupling between respiratory and cardiovascular systems (PSI_RES-PTT) immediately after intervention compared to baseline (p=0.002). Enhanced external counterpulsation significantly reduced the physiological coupling between respiratory and cardiovascular systems (PSI_RES-PTT 0.34 vs 0.49 at baseline, P=0.002) immediately after intervention in healthy adults.
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