Document Detail


Effects of intra-aortic balloon counterpulsation on coronary pressure in patients with stenotic coronary arteries.
MedLine Citation:
PMID:  17893000     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The benefits of intra-aortic balloon pumping (IABP) usage reportedly occur through systolic unloading of the left ventricle and the augmentation of diastolic coronary flow. The aim of this study was to assess the change in intracoronary pressure distal to the coronary stenosis after the IABP by using an intracoronary pressure wire. METHODS: Hemodynamic variables and intracoronary pressure data were measured in 16 patients requiring IABP for clinical indication (11 vessels with coronary stenosis and 5 normal vessels were enrolled). Coronary pressure was measured directly in each vessel with and without IABP support. RESULTS: The diastolic aortic pressure during IABP increased compared with that without the IABP (97.9 +/- 11.7 vs 80.3 +/- 10.7 mm Hg, P < .01). The systolic aortic and intracoronary pressure during the IABP decreased (aortic pressure: 83.8 +/- 10.4 vs 95.9 +/- 11.3 mm Hg, P < .01, intracoronary pressure: 67.6 +/- 16.5 vs 76.2 +/- 20.4 mm Hg, P < .01). The diastolic distal coronary pressure (Pd) increased during the IABP in healthy coronary arteries (87.3 +/- 4.8 vs 72.1 +/- 10.3 mm Hg, P < .05). However, Pd in stenotic coronary arteries with the IABP did not increase statistically compared with those without the IABP (44.0 +/- 21.3 vs 42.8 +/- 17.9 mm Hg). There was a significant correlation between the change in Pd after IABP insertion and percent diameter stenosis calculated by quantitative coronary angiography (r2 = 0.51, P < .001). CONCLUSIONS: In the presence of a critical coronary stenosis, the IABP does not increase the diastolic coronary pressure distal to the stenosis. Thus, the major effect of IABP on high-risk patients with severe coronary stenosis may relate to the reduction of oxygen demand by systolic unloading more than diastolic augmentation of the coronary flow.
Authors:
Hidetoshi Yoshitani; Takashi Akasaka; Shuichiro Kaji; Takahiro Kawamoto; Teruyoshi Kume; Yoji Neishi; Yuji Koyama; Kiyoshi Yoshida
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  American heart journal     Volume:  154     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-09-25     Completed Date:  2007-11-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  725-31     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine and Cardiology, Graduate School of Medicine, Osaka City University, Osaka, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary
Blood Pressure*
Coronary Angiography
Coronary Disease / therapy
Coronary Stenosis / physiopathology*
Coronary Vessels / physiopathology*
Diastole / physiology
Female
Humans
Intra-Aortic Balloon Pumping*
Male
Middle Aged
Oxygen Consumption / physiology
Systole / physiology
Comments/Corrections
Comment In:
Am Heart J. 2007 Oct;154(4):615-6   [PMID:  17892980 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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