Document Detail


Enhanced coronary flow velocity during intra-aortic balloon pumping assessed by transthoracic Doppler echocardiography.
MedLine Citation:
PMID:  15013116     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The study was done to determine potential utility of measuring coronary flow velocity (CFV) by transthoracic Doppler echocardiography (TTDE) during intra-aortic balloon pumping (IABP). BACKGROUND: Use of IABP has been shown to increase CFV assessed by an invasive technique. The CFV in the left anterior descending coronary artery (LAD) can be measured by TTDE. METHODS: Coronary flow velocity in the distal LAD by TTDE was measured in 40 critically ill patients requiring IABP. All patients received emergency coronary angiography. Both CFV and pressure data were obtained during 1:2 balloon pumping. RESULTS: Adequate diastolic CFV recording was obtained in all patients. The IABP decreased systolic pressure and increased diastolic pressure. Average peak diastolic flow velocity and diastolic velocity time integral was 19 +/- 11 cm/s and 7.7 +/- 4.4 cm with non-augmented beat. These values were increased significantly (61 +/- 38%, 59 +/- 35%, p < 0.001) with augmented beat. Significant correlation was noted between % diastolic pressure augmentation and % increase in diastolic CFV (r = 0.62 to 0.69, p < 0.001). There was no significant difference in flow enhancement during IABP, irrespective to the proximal LAD stenosis severity (severe stenosis: 73 +/- 70%; intermediate stenosis: 61 +/- 29%; no significant stenosis: 58 +/- 29%; p = NS, analysis of variance). By continuous recording of CFV, the optimal timing of balloon control could be adjusted to maximize flow velocity during augmentation. CONCLUSIONS: Use of TTDE can be employed in monitoring CFV augmentation during IABP. The IABP produced significant distal flow enhancement even in patients with critical proximal stenosis. This totally noninvasive approach may help to optimize the benefits of IABP for coronary flow augmentation.
Authors:
Masaaki Takeuchi; Yuichi Nohtomi; Hidetoshi Yoshitani; Chinami Miyazaki; Kazuo Sakamoto; Junichi Yoshikawa
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  43     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2004 Feb 
Date Detail:
Created Date:  2004-03-11     Completed Date:  2004-04-15     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  368-76     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine, Tane General Hospital, 1-2-31 Sakaigawa, Nishi-ku, Osaka 500-0024, Japan. masaaki_takeuchi@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Blood Flow Velocity / physiology*
Coronary Artery Disease / physiopathology*,  therapy,  ultrasonography
Coronary Circulation / physiology*
Coronary Vessels / physiopathology*,  ultrasonography
Echocardiography
Female
Humans
Intra-Aortic Balloon Pumping / methods*
Male
Middle Aged
Time Factors

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


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