BACKGROUND: The use of aortic counterpulsation therapy in advanced heart failure is controversial. OBJECTIVES: To evaluate the hemodynamic and metabolic effects of intra-aortic balloon pump (IABP) and its impact on 30-day mortality in patients with heart failure. METHODS: Historical prospective, unicentric study to evaluate all patients treated with IABP between August/2008 and July/2013, included in an institutional registry named TBRIDGE (The Brazilian Registry of Intra-aortic balloon pump in Decompensated heart failure - Global Evaluation). We analyzed changes in oxygen central venous saturation (ScvO2), arterial lactate, and use of vasoactive drugs at 48 hours after IABP insertion. The 30-day mortality was estimated by the Kaplan-Meier method and differences in subgroups were evaluated by the Log-rank test. RESULTS: A total of 223 patients (mean age 49 ± 14 years) were included. Mean left ventricle ejection fraction was 24 ± 10%, and 30% of patients had Chagas disease. Compared with pre-IABP insertion, we observed an increase in ScvO2 (50.5% vs. 65.5%, p < 0.001) and use of nitroprusside (33.6% vs. 47.5%, p < 0.001), and a decrease in lactate levels (31.4 vs. 16.7 mg/dL, p < 0.001) and use of vasopressors (36.3% vs. 25.6%, p = 0.003) after IABP insertion. Thirty-day survival was 69%, with lower mortality in Chagas disease patients compared without the disease (p = 0.008). CONCLUSION: After 48 hours of use, IABP promoted changes in the use of vasoactive drugs, improved tissue perfusion. Chagas etiology was associated with lower 30-day mortality. Aortic counterpulsation therapy is an effective method of circulatory support for patients waiting for heart transplantation.
BACKGROUND: The use of aortic counterpulsation therapy in advanced heart failure is controversial. OBJECTIVES: To evaluate the hemodynamic and metabolic effects of intra-aortic balloon pump (IABP) and its impact on 30-day mortality in patients with heart failure. METHODS: Historical prospective, unicentric study to evaluate all patients treated with IABP between August/2008 and July/2013, included in an institutional registry named TBRIDGE (The Brazilian Registry of Intra-aortic balloon pump in Decompensated heart failure - Global Evaluation). We analyzed changes in oxygen central venous saturation (ScvO2), arterial lactate, and use of vasoactive drugs at 48 hours after IABP insertion. The 30-day mortality was estimated by the Kaplan-Meier method and differences in subgroups were evaluated by the Log-rank test. RESULTS: A total of 223 patients (mean age 49 ± 14 years) were included. Mean left ventricle ejection fraction was 24 ± 10%, and 30% of patients had Chagas disease. Compared with pre-IABP insertion, we observed an increase in ScvO2 (50.5% vs. 65.5%, p < 0.001) and use of nitroprusside (33.6% vs. 47.5%, p < 0.001), and a decrease in lactate levels (31.4 vs. 16.7 mg/dL, p < 0.001) and use of vasopressors (36.3% vs. 25.6%, p = 0.003) after IABP insertion. Thirty-day survival was 69%, with lower mortality in Chagas diseasepatients compared without the disease (p = 0.008). CONCLUSION: After 48 hours of use, IABP promoted changes in the use of vasoactive drugs, improved tissue perfusion. Chagas etiology was associated with lower 30-day mortality. Aortic counterpulsation therapy is an effective method of circulatory support for patients waiting for heart transplantation.
Authors: T J Ryan; E M Antman; N H Brooks; R M Califf; L D Hillis; L F Hiratzka; E Rapaport; B Riegel; R O Russell; E E Smith; W D Weaver; R J Gibbons; J S Alpert; K A Eagle; T J Gardner; A Garson; G Gregoratos; S C Smith Journal: Circulation Date: 1999-08-31 Impact factor: 29.690
Authors: J J Ferguson; M Cohen; R J Freedman; G W Stone; M F Miller; D L Joseph; E M Ohman Journal: J Am Coll Cardiol Date: 2001-11-01 Impact factor: 24.094
Authors: T A Sanborn; L A Sleeper; E R Bates; A K Jacobs; J Boland; J K French; J Dens; V Dzavik; S T Palmeri; J G Webb; M Goldberger; J S Hochman Journal: J Am Coll Cardiol Date: 2000-09 Impact factor: 24.094
Authors: J S Hochman; L A Sleeper; J G Webb; T A Sanborn; H D White; J D Talley; C E Buller; A K Jacobs; J N Slater; J Col; S M McKinlay; T H LeJemtel Journal: N Engl J Med Date: 1999-08-26 Impact factor: 91.245
Authors: Gregg W Stone; E Magnus Ohman; Michael F Miller; Debra L Joseph; Jan T Christenson; Marc Cohen; Philip M Urban; Ramachandra C Reddy; Robert J Freedman; Karen L Staman; James J Ferguson Journal: J Am Coll Cardiol Date: 2003-06-04 Impact factor: 24.094
Authors: Marc Cohen; Philip Urban; Jan T Christenson; Debra L Joseph; Robert J Freedman; Michael F Miller; E Magnus Ohman; Ramachandra C Reddy; Gregg W Stone; James J Ferguson Journal: Eur Heart J Date: 2003-10 Impact factor: 29.983
Authors: Nuccia Morici; Giovanna Viola; Laura Antolini; Gianfranco Alicandro; Michela Dal Martello; Alice Sacco; Maurizio Bottiroli; Federico Pappalardo; Luca Villanova; Laura De Ponti; Carlo La Vecchia; Maria Frigerio; Fabrizio Oliva; Justin Fried; Paolo Colombo; Arthur Reshad Garan Journal: Int J Cardiol Heart Vasc Date: 2021-06-04