Key result
Intra-aortic balloon pump support generated compression and expansion waves whose energies correlated significantly with diastolic pressure augmentation (r=0.83) and end-diastolic pressure reduction.
Why the study?
Does intra-aortic balloon pump (IABP) support generate compression and expansion waves that explain its hemodynamic benefits in patients?
Observational (n=25)
Does intra-aortic balloon pump (IABP) support generate compression and expansion waves that explain its hemodynamic benefits in patients?
Absolute Event Rate: 43.9% vs 50.9%
p-value: p=<0.0001
The hemodynamic benefits of intra-aortic balloon pumping (diastolic augmentation and end-diastolic pressure reduction) are directly related to the energies of the compression and expansion waves generated by balloon inflation and deflation.
Wave intensity analysis links IABP waves to hemodynamic effects in patients; extends mechanistic data but leaves outcome impact open.
An explanation of the mechanisms leading to the beneficial hemodynamic effects of the intra-aortic balloon pump (IABP) is lacking. We hypothesized that inflation and deflation of the balloon would generate a compression (BCW) and an expansion (BEW) wave, respectively, which, when analyzed with wave intensity analysis, could be used to explain the hemodynamic benefits of IABP support. Simultaneous ascending aortic pressure (P(ao)) and flow rate (Q(ao)) were recorded in 25 patients during control conditions and with IABP support of 1:1 and 1:2. Diastolic aortic pressure augmentation (P(aug)) and end-diastolic aortic pressure (ED P(ao)) reduction were calculated from P(ao). Energies of the BCW and BEW were obtained by integrating the wave intensity contour over time. P(aug) was 19.1 mmHg (SD 13.6) during 1:2 support. During 1:1 support significantly higher P(aug) of 21.1 mmHg (SD 13.4) was achieved (P < 0.001). ED P(ao) decreased from 50.9 mmHg (SD 15.1) to 43.9 mmHg (SD 15.7) (P < 0.0001) during 1:1 assistance and the decrease was not statistically different with 1:2. During 1:1 support the energy of BCW was correlated positively to P(aug) (r = 0.83, P < 0.0001) and energy of the BEW correlated negatively to ED P(ao) (r = 0.78, P < 0.005); these relationships were not statistically different during 1:2. In conclusion, the energies of the BCW and BEW are directly related to P(aug) and ED P(ao), which are the conventional hemodynamic parameters indicating IABP benefits. These findings imply a cause and effect mechanism between the energies of BCW and BEW, and IABP hemodynamic effects.
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Kolyva et al. (2009) conducted an observational in Patients requiring intra-aortic balloon pump support (n=25). Intra-aortic balloon pump (IABP) support vs. Control conditions was evaluated on End-diastolic aortic pressure (ED P(ao)) (p=<0.0001). Intra-aortic balloon pump support generated compression and expansion waves whose energies correlated significantly with diastolic pressure augmentation (r=0.83) and end-diastolic pressure reduction.
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