Effects of electroacupuncture guided by the vessel-collateral theory on short-term ventricular remodeling following STEMI-PCI surgery: a randomized controlled clinical study

Based on the vessel-collateral theory, “qi deficiency and blood stasis leading to collateral obstruction and accumulation”, electroacupuncture was delivered in patients with ventricular remodeling after percutaneous coronary intervention (PCI) for acute ST-segment elevation myocardial infarction (STEMI), and the clinical efficacy was evaluated.

A prospective randomized controlled design was adopted. Eighty patients with cardiac insufficiency after STEMI-PCI (qi deficiency and blood stasis) were enrolled and randomly assigned to a control group (40 cases, with 2 cases dropped out) and an electroacupuncture group (40 cases, with 2 cases dropped out). In the control group, the standardized western medication was administered. In the electroacupuncture group, on the basis of the regimen as the control group, electroacupuncture was operated at Neiguan (PC6), Danzhong (CV17), Shenmen (HT7), Qihai (CV6), Xuehai (SP10) and Zusanli (ST36) with dense-disperse wave, at a frequency of 2 Hz/100 Hz, 30 min per session, once every other day, for 8 consecutive weeks. Three-dimensional speckle tracking echocardiography was used to detect cardiac function indicators: left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS), and cardiac structural indicators: left ventricular end-diastolic volume (LVEDV) and left ventricular end-systolic volume (LVESV) in both groups before and after treatment. ELISA was used to detect the serum levels of cardiac fibrosis markers: soluble suppression of tumorigenicity 2 (sST2) and galectin-3 (Gal-3); immunoturbidimetry was used to detect the heart failure marker: N-terminal pro-B-type natriuretic peptide (NT-proBNP). Changes in traditional Chinese medicine (TCM) syndrome scores were compared and the safety was evaluated in the two groups.

Compared with the control group, the electroacupuncture group showed the increase in LVEF and absolute value of GLS (P<0.01, P<0.001) and the decrease in LVEDV and LVESV (P<0.01, P<0.001) after treatment; serum fibrosis markers (sST2, Gal-3) levels were reduced (P<0.05, P<0.01), the serum heart failure marker (NT-proBNP) level was decreased (P<0.001), and the scores of TCM symptoms were improved (P<0.01, P<0.001). Gompared with before treatment, both groups showed improvement (P<0.001) in the above indicators after treatment. No serious adverse event was reported.

Electroacupuncture may conduce to ameliorating cardiac functions and ventricular remodeling indicators in patients after STEMI-PCI, which is probably related to the modulation of cardiac fibrosis markers in serum.