Document Detail


Wave intensity analysis of para-aortic counterpulsation.
MedLine Citation:
PMID:  22227124     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Wave intensity analysis (WIA) was used to delineate and maximize the efficacy of a newly developed para-aortic blood pump (PABP). The intra-aortic balloon pump (IABP) was employed as the comparison benchmark. Acute porcine experiments using eight pigs, randomly divided into IABP (n = 4) and PABP (n = 4) groups, were conducted to compare the characteristics of intra- and para-aortic counterpulsation. We measured pressure and velocity with probes installed in the left anterior descending coronary artery and aorta, during and without PABP assistance. Wave intensity for aortic and left coronary waves were derived from pressure and flow measurements with synchronization correction applied. To achieve maximized support efficacy, deflation timings ranging from 25 ms ahead of to 35 ms after the R-wave were tested. Similar to those associated with IABP counterpulsation, the PABP-generated backward-traveling waves predominantly drove aortic and coronary blood flows. However, in contrast with IABP counterpulsation, the nonocclusive nature of the PABP allowed systolic unloading to be delayed into early systole, which resulted in near elimination of coronary blood steal without diminution of systolic left ventricular ejection wave intensities. WIA can elucidate subtleties among different counterpulsatile support means with high sensitivity. Total accelerating wave intensity (TAWI), which was defined as the sum of the time integration of accelerated parts of the positive and negative wave intensities, was used to quantify counterpulsation efficacy. In general, the larger the TAWI gain, the better the counter-pulsatile support efficacy. However, when PABP deflation timings were delayed to after the R-wave, the TAWI was found to be inversely correlated with coronary perfusion. In this delayed deflation timing setting, greater wave cancellation occurred, which led to decreased TAWI but increased coronary perfusion attributed to blood regurgitation reduction.
Authors:
Pong-Jeu Lu; Chi-Fu Jeffrey Yang; Meng-Yu Wu; Chun-Hao Hung; Ming-Yao Chan; Tzu-Cheng Hsu
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-01-06
Journal Detail:
Title:  American journal of physiology. Heart and circulatory physiology     Volume:  302     ISSN:  1522-1539     ISO Abbreviation:  Am. J. Physiol. Heart Circ. Physiol.     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-04-02     Completed Date:  2012-05-15     Revised Date:  2012-05-23    
Medline Journal Info:
Nlm Unique ID:  100901228     Medline TA:  Am J Physiol Heart Circ Physiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  H1481-91     Citation Subset:  IM    
Affiliation:
Department of Aeronautics and Astronautics, National Cheng Kung University, Tainan, Taiwan. pjlu@mail.ncku.edu.tw
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MeSH Terms
Descriptor/Qualifier:
Algorithms
Animals
Coronary-Subclavian Steal Syndrome / physiopathology
Counterpulsation / methods*
Data Interpretation, Statistical
Electrocardiography
Intra-Aortic Balloon Pumping / methods*
Stroke Volume / physiology
Swine
Swine, Miniature
Wavelet Analysis*
Grant Support
ID/Acronym/Agency:
//Howard Hughes Medical Institute

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


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