Key result
A 32-ml implantable counterpulsation device produced similar increases in cardiac output (6% vs 5%, p>0.5) and greater reductions in myocardial oxygen consumption compared to a 40-ml IABP.
Why the study?
Does a 32-ml subcutaneous counterpulsation device improve acute hemodynamics compared to a standard 40-ml intra-aortic balloon pump in a calf model of diminished cardiac function?
Does a 32-ml subcutaneous counterpulsation device improve acute hemodynamics compared to a standard 40-ml intra-aortic balloon pump in a calf model of diminished cardiac function?
A novel 32-ml subcutaneous counterpulsation device provides equivalent hemodynamic support to a standard IABP with potentially greater reduction in myocardial oxygen consumption in a preclinical heart failure model.
Should not change IABP practice; leaves open whether smaller implantable counterpulsation devices merit human trials.
The acute hemodynamic efficacy of an implantable counterpulsation device (CPD) was evaluated. The CPD is a valveless single port, 32-ml stroke volume blood chamber designed to be connected to the human axillary artery using a simple surface surgical procedure. Blood is drawn into the pump during systole and ejected during diastole. The acute hemodynamic effects of the 32-ml CPD were compared to a standard clinical 40-ml intra-aortic balloon pump (IABP) in calves (80 kg, n = 10). The calves were treated by a single oral dose of Monensin to produce a model of diminished cardiac function (DCF). The CPD and IABP produced similar increases in cardiac output (6% CPD vs. 5% IABP, p > 0.5) and reduction in left ventricular external work (14% CPD vs. 13% IABP, p > 0.5) compared to DCF (p < 0.05). However, the ratio of diastolic coronary artery flow to left ventricular external work increase from DCF baseline (p < 0.05) was greater with the CPD compared to the IABP (15% vs. 4%, p < 0.05). The CPD also produced a greater reduction in left ventricular myocardial oxygen consumption from DCF baseline (p < 0.05) compared to the IABP (13% vs. 9%, p < 0.05) despite each device providing similar improvements in cardiac output. There was no early indication of hemolysis, thrombus formation, or vascular injury. The CPD provides hemodynamic efficacy equivalent to an IABP and may become a therapeutic option for patients who may benefit from prolonged counterpulsation.
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Koenig et al. (2008) studied Diminished cardiac function (n=10). Implantable counterpulsation device (CPD) vs. 40-ml intra-aortic balloon pump (IABP) was evaluated on Increase in cardiac output (p=> 0.5). A 32-ml implantable counterpulsation device produced similar increases in cardiac output (6% vs 5%, p>0.5) and greater reductions in myocardial oxygen consumption compared to a 40-ml IABP.
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