Intra-aortic balloon counterpulsation in acute myocardial infarction: old and emerging indications

Nunen, van Lx Lokien; Veer, van 't Marcel Marcel; Schampaert, S Stéphanie; Steerneman, Bjem; Rutten, Mcm Marcel; Vosse, van de Fn Frans; Pijls, Nico Nico

doi:10.1007/s12471-013-0485-9

Cited by 8 publications

(12 citation statements)

References 21 publications

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“…From a pathophysiological point of view, the main feature of death in AMI-cardiogenic shock is unstable hemodynamics with reduced systolic and mean arterial pressures that lead to reduced oxygen supply to vital organs [ 9 ], while the IABP can give hemodynamic support to these hemodynamically unstable patients by increasing blood flow to the heart and decreasing the cardiac workload [ 2 ]. However, the reason why the mortality of AMI-cardiogenic shock patients was not sufficiently reduced may be because the effects on cardiac output are modest [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

The Preference, Effect, and Prognosis of Intra‐Aortic Balloon Counterpulsation in Acute Myocardial Infarction Complicated by Cardiogenic Shock Patients: A Retrospective Cohort Study

Wang

Yang

Lin

et al. 2021

BioMed Research International

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Backgrounds. Intra-aortic balloon counterpulsation is increasingly used in acute myocardial infarction complicated by cardiogenic shock. The aim of this study was to explore the preference, effect, and prognosis of intra-aortic balloon counterpulsation in acute myocardial infarction complicated by cardiogenic shock patients. Methods. Data of acute myocardial infarction complicated by cardiogenic shock patients at the Fourth Medical Center of PLA General Hospital were collected retrospectively. A propensity score was calculated with a logistic regression which contained clinically meaningful variables and variables selected by Lasso and then used to match the control group. The cumulative incidence curve and Gray’s test were employed to analyse the effect and prognosis of intra-aortic balloon counterpulsation on mortality. Results. A total of 1962 acute myocardial infarction cases admitted between May 2015 and November 2018 were identified, and 223 cases with acute myocardial infarction complicated by cardiogenic shock were included as the study cohort, which contained 34 cases that received IABP and 189 cases that did not receive IABP. Patients with higher alanine aminotransferase ( OR = 1.93 , 95% CI 1.29-2.98), higher triglyceride ( OR = 3.71 , 95% CI 1.87-7.95), and higher blood glucose ( OR = 1.08 , 95% CI 0.99-1.18) had a higher probability of receiving intra-aortic balloon counterpulsation. In the propensity score matching analysis, 34 cases received intra-aortic balloon counterpulsation and 102 matched controls were included in the comparison. By comparing the cumulative incidence of in-hospital mortality, there was no statistically significant difference between the intra-aortic balloon counterpulsation group and matched control group ( P = 0.454 ). Conclusion. The use of intra-aortic balloon counterpulsation may not improve the prognosis of the acute myocardial infarction complicated by cardiogenic shock patients.

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Section: Discussionmentioning

confidence: 99%

The Preference, Effect, and Prognosis of Intra‐Aortic Balloon Counterpulsation in Acute Myocardial Infarction Complicated by Cardiogenic Shock Patients: A Retrospective Cohort Study

Wang

Yang

Lin

et al. 2021

BioMed Research International

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“…A recent retrospective analysis of Van Nunen et al. showed that the outcome in these patients is favorable and mandates further prospective studies. Another clinical scenario resembling these conditions exists inside the patient after coronary bypass surgery with good bypasses but transient myocardial stunning due to prolonged extracorporeal circulation .…”

Section: Discussionmentioning

confidence: 99%

Intra‐Aortic Balloon Pump Support in the Isolated Beating Porcine Heart in Nonischemic and Ischemic Pump Failure

et al. 2015

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The blood pressure changes induced by the intra-aortic balloon pump (IABP) are expected to create clinical improvement in terms of coronary perfusion and myocardial oxygen consumption. However, the measured effects reported in literature are inconsistent. The aim of this study was to investigate the influence of ischemia on IABP efficacy in healthy hearts and in shock. Twelve slaughterhouse porcine hearts (hearts 1-12) were connected to an external circulatory system, while physiologic cardiac performance was restored. Different clinical scenarios, ranging from healthy to cardiogenic shock, were simulated by step-wise administration of negative inotropic drugs. In hearts 7-12, severe global myocardial ischemia superimposed upon the decreased contractile states was created. IABP support was applied in all hearts under all conditions. Without ischemia, the IABP induced a mild increase in coronary blood flow and cardiac output. These effects were strongly augmented in the presence of persisting ischemia, where coronary blood flow increased by 49 ± 24% (P < 0.01) and cardiac output by 17 ± 6% (P < 0.01) in case of severe pump failure. As expected, myocardial oxygen consumption increased in case of ischemia (21 ± 17%; P < 0.01), while it slightly decreased without (-3 ± 6%; P < 0.01). In case of progressive pump failure due to persistent myocardial ischemia, the IABP increased hyperemic coronary blood flow and cardiac output significantly, and reversed the progressive hemodynamic deterioration within minutes. This suggests that IABP therapy in acute myocardial infarction is most effective in patients with viable myocardium, suffering from persistent myocardial ischemia, despite adequate epicardial reperfusion.

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“…IABP use should therefore be considered where effective revascularisation cannot immediately be delivered or where the device's effects may ameliorate severe or prolonged peri-procedural ischaemia. The SEMPER FI trial, currently in recruitment and due to complete in December 2018, will address this hypothesis 31). Common such situations include patients awaiting primary revascularisation with CABG or with acute mitral regurgitation or ventricular septal defects.…”

Section: Evidence For Use In Cardiogenic Shockmentioning

confidence: 99%

Mechanical Circulatory Support in the Cardiac Catheterization Laboratory for Cardiogenic Shock

2019

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Despite the development of acute revascularisation, the mortality rate for cardiogenic shock remains around 50%. Mechanical circulatory support devices have long held promise in improving outcomes in shock, but high-quality evidence of benefit has not been forthcoming. In this article we review the currently available devices for treating shock, their physiological effects and the evidence base for their use in practice. We subsequently look ahead within this developing field, including new devices and novel indications for established technology.

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Intra-aortic balloon counterpulsation in acute myocardial infarction: old and emerging indications

Cited by 8 publications

References 21 publications

The Preference, Effect, and Prognosis of Intra‐Aortic Balloon Counterpulsation in Acute Myocardial Infarction Complicated by Cardiogenic Shock Patients: A Retrospective Cohort Study

The Preference, Effect, and Prognosis of Intra‐Aortic Balloon Counterpulsation in Acute Myocardial Infarction Complicated by Cardiogenic Shock Patients: A Retrospective Cohort Study

Intra‐Aortic Balloon Pump Support in the Isolated Beating Porcine Heart in Nonischemic and Ischemic Pump Failure

Mechanical Circulatory Support in the Cardiac Catheterization Laboratory for Cardiogenic Shock

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