P5.21 EARLY IABP INFLATION SUPPRESSES LEFT VENTRICULAR FUNCTION AS INDICATED BY WAVE INTENSITY ANALYSIS

DOI

10.1016/j.artres.2013.10.169How to use a DOI?

Abstract

Background: Timing errors during Intra-Aortic Balloon Pump (IABP) support can be detrimental when interfering with cardiac function. In vivo hemodynamics and left ventricular (LV) function were monitored during premature IAB inflation, and the associated mechanisms investigated with Wave Intensity Analysis.

Methods: Six healthy, anaesthetised, open-chest sheep received IABP support with frequency 1:3 (n=3) and 1:1 (n=3). Aortic (Qao) and coronary (Qcor) flow, and aortic (Pao) and left ventricular (PLV) pressure were recorded simultaneously with and without IABP. Early inflation (EI) was triggered -91±9ms (1:3) and −105±36ms (1:1) before the incisura. Integrating systolic Qao and subsequent negative Qao yielded stroke volume (SV) and backflow, respectively. Forward expansion (FEW) and forward compression (FCW) wave energies, generated by the slowing of LV contraction preceding inflation and by early LV ejection following deflation, respectively, were obtained. Results are mean±standard deviation.

Results: EI increased diastolic (d) Qcor in 1:3 but not in 1:1. EI appears to be detrimental for LV function, as indicated by substantial FEW reduction in both frequencies, concurring with increased backflow. Systolic (s) Pao and PLV did not corroborate suppressed LV function, but SV tended to decrease at 1:3 in the systole preceding EI. FCW reduction was also observed.

	IABP on		IABP off
	1:3	1:1	1:3	1:1
FEW (J/m2)	0.026±0.015*	0.031±0.017*	0.059±0.026	0.073±0.026
FCW (J/m2)	0.117±0.044*	0.086±0.051*	0.147±0.048	0.087±0.060
SV (ml)	67±16	78±28	71±17	77±32
Backflow (ml)	3.0±0.3*	4.410.9*	1.8±0.3	3.1±0.4
dQcor (ml/min)	182±17*	148±6*	150±17	149±36
sPLV (mmHg)	67±10	69±5*	67±13	76±7
sPao (mmHg)	71±11	73±8*	71±13	81±8

*

P<0.05 comparing EI to off,

#

P<0.05 comparing 1:1 to 1:3.

Conclusion: With the aortic valve still open during EI, the IABP may displace blood directly into the LV and interrupt late LV ejection, as demonstrated by reduced FEW energy. Coronary perfusion is not affected by this mechanism. Concurrent reduction in FCW energy, albeit not exclusively caused by EI, further indicates compromised LV function.

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TY  - JOUR
AU  - C. Kolyva
AU  - G.M. Pantalos
AU  - J.R. Pepper
AU  - A.W. Khir
PY  - 2013
DA  - 2013/11/11
TI  - P5.21 EARLY IABP INFLATION SUPPRESSES LEFT VENTRICULAR FUNCTION AS INDICATED BY WAVE INTENSITY ANALYSIS
JO  - Artery Research
SP  - 149
EP  - 149
VL  - 7
IS  - 3-4
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2013.10.169
DO  - 10.1016/j.artres.2013.10.169
ID  - Kolyva2013
ER  -