Hemodynamic and cardiac metabolic effects of diastolic intraaortic balloon obstruction combined with distal aortic “booster” occlusion in experimental acute myocardial infarction with shock

Kuhn, Leslie A.; Unger, Allen H.; Novick, Stephen A.; Marano, Anthony J.; Rosenberg, Alan S.

doi:10.1016/0002-9149(70)90899-4

The American Journal of Cardiology

1970

DOI: 10.1016/0002-9149(70)90899-4

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Hemodynamic and cardiac metabolic effects of diastolic intraaortic balloon obstruction combined with distal aortic “booster” occlusion in experimental acute myocardial infarction with shock

Leslie A. Kuhn¹,

Allen H. Unger²,

Stephen A. Novick³

et al.

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Cited by 6 publications

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“…Recent studies have suggested that intra-aortic counterpulsation (IACP) may decrease ventricular work and increase oxygen delivery in coronary shock (10,(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29). Detailed studies of myocardial metabolism with IACP have not been reported, however.…”

mentioning

confidence: 99%

The effects of intra-aortic counterpulsation on cardiac performance and metabolism in shock associated with acute myocardial infarction

Mueller¹,

Ayres²,

Conklin³

et al. 1971

J. Clin. Invest.

145

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A B S T R A C T The effect of intra-aortic counterpulsation (IACP, 22-94 hr) on hemodynamics and cardiac energetics was evaluated in 10 patients in shock after acute myocardial infarction. The data clearly indicate that IACP improves myocardial oxygenation, enhances peripheral perfusion, and probably improves myocardial contractility in the severely diseased heart.Before treatment, decreases in cardiac index (mean value, 1.22 liter/min per m'), systolic ejection rate (67 ml/sec), and time-tension index per minute (1280 mm Hg -sec/min) were observed. Systemic vascular resistance varied widely. Low coronary blood flow (68 ml/min per 100 g) was associated with increased myocardial oxygen extraction (79%), low coronary sinus oxygen tension (20 mm Hg), and abnormal myocardial lactate-pyruvate metabolism.During 4-6 hr of IACP, systolic pressure and left ventricular outflow resistance decreased by 18% and 24%, respectively, while cardiac index improved by 38%. Diastolic arterial pressure rose 98%. Increase in coronary blood flow from an average of 68 to 91 ml/100 g per min (P < 0.001) was significantly correlated with rise in mean arterial pressure (r = 0.685). This correlation was best expressed in a third-order curve, which intercepts the point of no flow at a mean aortic pressure of 30 mm Hg. The flow-pressure curve is relatively flat above 65-70 mm Hg, but becomes steeper as mean aortic pressure falls below this point. Myocardial oxygen consumption remained essentially unchanged during early IACP and tended to rise during the later stages.However, the relationship of cardiac work performed to oxygen availability was markedly improved. Myocardial

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mentioning

confidence: 99%

The effects of intra-aortic counterpulsation on cardiac performance and metabolism in shock associated with acute myocardial infarction

Mueller¹,

Ayres²,

Conklin³

et al. 1971

J. Clin. Invest.

145

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Current status of diastolic augmentation for circulatory support

Kuhn

1971

American Heart Journal

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Intraaortic Balloon Counterpulsation: A Review of Physiological Principles, Clinical Results, and Device Safety

Weber¹,

Janicki²

1974

The Annals of Thoracic Surgery

198

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Hemodynamic and cardiac metabolic effects of diastolic intraaortic balloon obstruction combined with distal aortic “booster” occlusion in experimental acute myocardial infarction with shock

Cited by 6 publications

References 0 publications

The effects of intra-aortic counterpulsation on cardiac performance and metabolism in shock associated with acute myocardial infarction

The effects of intra-aortic counterpulsation on cardiac performance and metabolism in shock associated with acute myocardial infarction

Current status of diastolic augmentation for circulatory support

Intraaortic Balloon Counterpulsation: A Review of Physiological Principles, Clinical Results, and Device Safety

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