| Effects of left ventricular unloading by Impella recover LP2.5 on coronary hemodynamics. | |
| | |
MedLine Citation:
|
PMID: 17896398 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVES: We studied the effects of LV unloading by the Impella on coronary hemodynamics by simultaneously measuring intracoronary pressure and flow and the derived parameters fractional flow reserve (FFR), coronary flow velocity reserve (CFVR), and coronary microvascular resistance (MR). BACKGROUND: Patients with compromised left ventricular (LV) function undergoing high-risk percutaneous coronary intervention (PCI) may benefit from LV unloading. Limited information is available on the effects of LV unloading on coronary hemodynamics. METHODS: Eleven patients (mean LV ejection fraction of 35 +/- 11%) underwent PCI during LV support by the LV unloading device (Impella Recover LP2.5). Intracoronary measurements were performed in a nonstenotic coronary artery after the PCI, before and after adenosine-induced hyperemia at four different support levels (0-2.5 L/min). RESULTS: Aortic and coronary pressure increased with increasing support levels, whereas FFR remained unchanged. Baseline flow velocity remained unchanged, while hyperemic flow velocity and CFVR increased significantly with increasing support levels (61 +/- 24 to 72 +/- 27 cm/sec, P = 0.001 and 1.88 +/- 0.52 to 2.34 +/- 0.63, P < 0.001 respectively). The difference between baseline MR and hyperemic MR significantly increased with increasing support levels (1.28 +/- 1.32 to 1.89 +/- 1.43 mm Hg cm(-1) sec, P = 0.005). CONCLUSIONS: Unloading of the LV by the Impella increased aortic and intracoronary pressure, hyperemic flow velocity and CFVR, and decreased MR. The Impella-induced increase in coronary flow, probably results from both an increased perfusion pressure and a decreased LV volume-related intramyocardial resistance. |
| | |
Authors:
|
Maurice Remmelink; Krischan D Sjauw; José P S Henriques; Robbert J de Winter; Karel T Koch; René J van der Schaaf; Marije M Vis; Jan G P Tijssen; Jan J Piek; Jan Baan |
Related Documents
:
|
6444388 - Diastolic pressure-volume relations in the diseased heart. 8644648 - Prediction of the left ventricular mass from the electrocardiogram in systemic hyperten... 2912568 - Variability and reproducibility of quantitative left ventricular angiography. 7046658 - The effect of peep on left ventricular diastolic dimensions and systolic performance fo... 7295468 - A study of the antihypertensive action of xipamide using ambulatory intra-arterial moni... 9038978 - Capacitive function of the heart: influence of acute changes in heart volume on mean ri... |
Publication Detail:
|
Type: Clinical Trial; Journal Article |
Journal Detail:
|
Title: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions Volume: 70 ISSN: 1522-1946 ISO Abbreviation: Catheter Cardiovasc Interv Publication Date: 2007 Oct |
Date Detail:
|
Created Date: 2007-10-02 Completed Date: 2008-01-10 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 100884139 Medline TA: Catheter Cardiovasc Interv Country: United States |
Other Details:
|
Languages: eng Pagination: 532-7 Citation Subset: IM |
Copyright Information:
|
(c) 2007 Wiley-Liss, Inc. |
Affiliation:
|
Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Angioplasty, Transluminal, Percutaneous Coronary* Aorta / physiopathology Blood Flow Velocity Blood Pressure Coronary Artery Disease / complications, physiopathology, therapy* Coronary Circulation* Female Fractional Flow Reserve, Myocardial Heart Catheterization Heart-Assist Devices* Humans Hyperemia / physiopathology Male Microcirculation / physiopathology Middle Aged Severity of Illness Index Stroke Volume Vascular Resistance Ventricular Dysfunction, Left / etiology*, physiopathology, therapy |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: The effect of drug eluting stents on cardiovascular events in patients with intermediate lesions and...
Next Document: On-site immediate removal of intraortic balloon pump after high-risk percutaneous intervention with ...