Key result
Early IABP inflation (0.09 s before the dicrotic notch) with a 0.25 s duration decreased efferent sympathetic activity by 15.3% and reduced peripheral resistance and heart rate by 4% and 4.3%.
Why the study?
Does intra-aortic balloon pump timing and duration affect baroreflex activities in a cardiovascular hybrid model?
Does intra-aortic balloon pump timing and duration affect baroreflex activities in a cardiovascular hybrid model?
Optimum IABP triggering time results in positive effects on peripheral circulation autonomic controls in a hybrid model, whereas improper timing may increase peripheral resistance and heart rate.
Early IABP timing may modulate baroreflex activity in models; leaves open clinical effects and requires human validation.
Despite 50 years of research to assess the intra‐aortic balloon pump (IABP) effects on patients' hemodynamics, some issues related to the effects of this therapy are still not fully understood. One of these issues is the effect of IABP, its inflation timing and duration on peripheral circulation autonomic controls. This work provides a systematic analysis of IABP effects on baroreflex using a cardiovascular hybrid model, which consists of computational and hydraulic submodels. The work also included a baroreflex computational model that was connected to a hydraulic model with a 40‐cm 3 balloon. The IABP was operated at different inflation trigger timings (−0.14 to 0.31 s) and inflation durations (0.05–0.45 s), with time of the dicrotic notch being taken as t = 0. Baroreflex‐dependent parameters—afferent and efferent pathway activity, heart rate, peripheral resistance, and venous tone—were evaluated at each of the inflation trigger times and durations considered. Balloon early inflation (0.09 s before the dicrotic notch) with inflation duration of 0.25 s generated a maximum net increment of afferent pathway activity of 10%, thus leading to a decrement of efferent sympathetic activity by 15.3% compared with baseline values. These times also resulted in a reduction in peripheral resistance and heart rate by 4 and 4.3% compared with baseline value. We conclude that optimum IABP triggering time results in positive effects on peripheral circulation autonomic controls. Conversely, if the balloon is not properly timed, peripheral resistance and heart rate may even increase, which could lead to detrimental outcomes.
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Fresiello et al. (2012) studied this question. Intra-aortic balloon pump (IABP) inflation timing and duration vs. Baseline values was evaluated on Baroreflex-dependent parameters (afferent and efferent pathway activity, heart rate, peripheral resistance, and venous tone). Early IABP inflation (0.09 s before the dicrotic notch) with a 0.25 s duration decreased efferent sympathetic activity by 15.3% and reduced peripheral resistance and heart rate by 4% and 4.3%.
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