Περίληψη:
Background: Studies of the IABP have reported variable effects on
coronary blood flow (CBF). The purpose of the present study was to
measure the changes in coronary blood flow induced by intra-aortic
balloon pump (IABP) counterpulsation in normal and reperfused porcine
myocardium.
Methods: A 30-ml IABP was placed in the descending aorta of 6 open-chest
pigs. Each pig underwent occlusion of the mid-left anterior descending
(LAD) coronary artery for 1 h, followed by reperfusion for 2 h. The
effects of IABP support on systolic aortic pressure (SAP) and aortic
end-diastolic pressure were recorded. The mean CBF, distal to the LAD
occlusion site was measured at baseline and during reperfusion, with and
without IABP counterpulsation.
Results: The IABP decreased SAP and aortic end-diastolic pressure in
normal and reperfused myocardium, and maintained a peak aortic diastolic
augmentation at the level of SAP. In normal myocardium, the IABP
decreased mean CBF by 8.4+/-2.2% (p<0.001). At 2, 15, 30, 60, 90 and
120 min of reperfusion, the IABP increased mean CBF by 11.5+/-6.8%,
8.0+/-7.0%, 11.2+/-6.9%, 12.4+/-12.9%, 23.5+/-9.9% and 8.9+/-6.9%,
of the corresponding value without the assistance of the IABP (all
p<0.05).
Conclusions: In the normal heart, IABP counterpulsation decreased CBF,
probably because of a decrease in myocardial oxygen demand from a
decreased afterload. During reperfusion the IABP increased CBF,
suggesting that it might effectively mitigate the no-reflow phenomenon.
(C) 2008 Elsevier Ireland Ltd. All rights reserved.
Συγγραφείς:
Bonios, Michael J.
Pierrakos, Charalampos N.
Argiriou, Michael
and Dalianis, Argirios
Terrovitis, John V.
Dolou, Paraskevi and
Drakos, Stavros G.
Koudoumas, Dimitrios
Charitos, Christos E.
and Anastasiou-Nana, Maria I.
