The effect of intra-aortic balloon counterpulsation on left ventricular functional recovery early after acute myocardial infarction: A randomized experimental magnetic resonance imaging study

Clerio F. Azevedo, Luciano C. Amado, Dara Kraitchman, Bernhard L. Gerber, Thor Edvardsen, Nael Fakhry Osman, Carlos E. Rochitte, Katherine Chih-Ching Wu, Joao Lima

Research output: Contribution to journalArticle

Abstract

Aims: We sought to determine whether intra-aortic balloon pump (IABP) counterpulsation improves the recovery of left ventricular (LV) systolic function after reperfused acute myocardial infarction (AMI). Methods and results: Fourteen dogs underwent 90-min coronary artery occlusion followed by reperfusion. Seven animals were randomized to IABP counterpulsation immediately after reperfusion. Tagged, cine, and contrast-enhanced magnetic resonance imaging were used for regional and global LV functional assessment and MI characterization, respectively. Image acquisition was performed at 1 h, 6 h, and 24 h after reperfusion, during which the IABP device was paused. Animals randomized to IABP demonstrated an earlier improvement of LV ejection fraction when compared with controls (25 ± 3 vs. 25 ± 2% at 1 h, P = 0.91; 36 ± 3 vs. 26 ± 2% at 6 h, P = 0.015; and 38 ± 3 vs. 35 ± 1% at 24 h, P = 0.34). Regional functional analyses revealed the same behaviour among non-infarcted risk regions, i.e., earlier circumferential systolic strain improvement in the IABP group than in controls (-5.4 ± 0.4 vs. -5.3 ± 0.5% at 1 h, P = 0.86; -12.1 ± 1.0 vs. -6.0 ± 0.4% at 6h, P<0.001; and -13.9 ± 1.1% vs. -12.8 ± 0.6% at 24h, P = 0.40). Importantly, however, the degree of LV functional recovery 24 h after reperfusion was similar whether IABP counterpulsation was used or not. Conclusion: IABP counterpulsation accelerates but does not significantly improve the recovery of LV systolic function after reperfused AMI.

Original languageEnglish (US)
Pages (from-to)1235-1241
Number of pages7
JournalEuropean Heart Journal
Volume26
Issue number12
DOIs
StatePublished - Jun 2005

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Counterpulsation
Reperfusion
Myocardial Infarction
Magnetic Resonance Imaging
Left Ventricular Function
Coronary Occlusion
Stroke Volume
Coronary Vessels
Dogs
Equipment and Supplies
Control Groups

Keywords

  • Intra-aortic balloon pump
  • Magnetic resonance imaging
  • Myocardial infarction
  • Myocardial stunning

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

The effect of intra-aortic balloon counterpulsation on left ventricular functional recovery early after acute myocardial infarction : A randomized experimental magnetic resonance imaging study. / Azevedo, Clerio F.; Amado, Luciano C.; Kraitchman, Dara; Gerber, Bernhard L.; Edvardsen, Thor; Osman, Nael Fakhry; Rochitte, Carlos E.; Wu, Katherine Chih-Ching; Lima, Joao.

In: European Heart Journal, Vol. 26, No. 12, 06.2005, p. 1235-1241.

Research output: Contribution to journalArticle

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abstract = "Aims: We sought to determine whether intra-aortic balloon pump (IABP) counterpulsation improves the recovery of left ventricular (LV) systolic function after reperfused acute myocardial infarction (AMI). Methods and results: Fourteen dogs underwent 90-min coronary artery occlusion followed by reperfusion. Seven animals were randomized to IABP counterpulsation immediately after reperfusion. Tagged, cine, and contrast-enhanced magnetic resonance imaging were used for regional and global LV functional assessment and MI characterization, respectively. Image acquisition was performed at 1 h, 6 h, and 24 h after reperfusion, during which the IABP device was paused. Animals randomized to IABP demonstrated an earlier improvement of LV ejection fraction when compared with controls (25 ± 3 vs. 25 ± 2{\%} at 1 h, P = 0.91; 36 ± 3 vs. 26 ± 2{\%} at 6 h, P = 0.015; and 38 ± 3 vs. 35 ± 1{\%} at 24 h, P = 0.34). Regional functional analyses revealed the same behaviour among non-infarcted risk regions, i.e., earlier circumferential systolic strain improvement in the IABP group than in controls (-5.4 ± 0.4 vs. -5.3 ± 0.5{\%} at 1 h, P = 0.86; -12.1 ± 1.0 vs. -6.0 ± 0.4{\%} at 6h, P<0.001; and -13.9 ± 1.1{\%} vs. -12.8 ± 0.6{\%} at 24h, P = 0.40). Importantly, however, the degree of LV functional recovery 24 h after reperfusion was similar whether IABP counterpulsation was used or not. Conclusion: IABP counterpulsation accelerates but does not significantly improve the recovery of LV systolic function after reperfused AMI.",
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T2 - A randomized experimental magnetic resonance imaging study

AU - Azevedo, Clerio F.

AU - Amado, Luciano C.

AU - Kraitchman, Dara

AU - Gerber, Bernhard L.

AU - Edvardsen, Thor

AU - Osman, Nael Fakhry

AU - Rochitte, Carlos E.

AU - Wu, Katherine Chih-Ching

AU - Lima, Joao

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N2 - Aims: We sought to determine whether intra-aortic balloon pump (IABP) counterpulsation improves the recovery of left ventricular (LV) systolic function after reperfused acute myocardial infarction (AMI). Methods and results: Fourteen dogs underwent 90-min coronary artery occlusion followed by reperfusion. Seven animals were randomized to IABP counterpulsation immediately after reperfusion. Tagged, cine, and contrast-enhanced magnetic resonance imaging were used for regional and global LV functional assessment and MI characterization, respectively. Image acquisition was performed at 1 h, 6 h, and 24 h after reperfusion, during which the IABP device was paused. Animals randomized to IABP demonstrated an earlier improvement of LV ejection fraction when compared with controls (25 ± 3 vs. 25 ± 2% at 1 h, P = 0.91; 36 ± 3 vs. 26 ± 2% at 6 h, P = 0.015; and 38 ± 3 vs. 35 ± 1% at 24 h, P = 0.34). Regional functional analyses revealed the same behaviour among non-infarcted risk regions, i.e., earlier circumferential systolic strain improvement in the IABP group than in controls (-5.4 ± 0.4 vs. -5.3 ± 0.5% at 1 h, P = 0.86; -12.1 ± 1.0 vs. -6.0 ± 0.4% at 6h, P<0.001; and -13.9 ± 1.1% vs. -12.8 ± 0.6% at 24h, P = 0.40). Importantly, however, the degree of LV functional recovery 24 h after reperfusion was similar whether IABP counterpulsation was used or not. Conclusion: IABP counterpulsation accelerates but does not significantly improve the recovery of LV systolic function after reperfused AMI.

AB - Aims: We sought to determine whether intra-aortic balloon pump (IABP) counterpulsation improves the recovery of left ventricular (LV) systolic function after reperfused acute myocardial infarction (AMI). Methods and results: Fourteen dogs underwent 90-min coronary artery occlusion followed by reperfusion. Seven animals were randomized to IABP counterpulsation immediately after reperfusion. Tagged, cine, and contrast-enhanced magnetic resonance imaging were used for regional and global LV functional assessment and MI characterization, respectively. Image acquisition was performed at 1 h, 6 h, and 24 h after reperfusion, during which the IABP device was paused. Animals randomized to IABP demonstrated an earlier improvement of LV ejection fraction when compared with controls (25 ± 3 vs. 25 ± 2% at 1 h, P = 0.91; 36 ± 3 vs. 26 ± 2% at 6 h, P = 0.015; and 38 ± 3 vs. 35 ± 1% at 24 h, P = 0.34). Regional functional analyses revealed the same behaviour among non-infarcted risk regions, i.e., earlier circumferential systolic strain improvement in the IABP group than in controls (-5.4 ± 0.4 vs. -5.3 ± 0.5% at 1 h, P = 0.86; -12.1 ± 1.0 vs. -6.0 ± 0.4% at 6h, P<0.001; and -13.9 ± 1.1% vs. -12.8 ± 0.6% at 24h, P = 0.40). Importantly, however, the degree of LV functional recovery 24 h after reperfusion was similar whether IABP counterpulsation was used or not. Conclusion: IABP counterpulsation accelerates but does not significantly improve the recovery of LV systolic function after reperfused AMI.

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KW - Magnetic resonance imaging

KW - Myocardial infarction

KW - Myocardial stunning

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