Arterial elastance modulation by intra-aortic balloon counterpulsation in patients with acute decompensated heart failure and low-output state

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Alice Sacco ◽  
Guido Tavazzi ◽  
Nuccia Morici ◽  
Giovanna Viola ◽  
Paolo Meani ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Arterial Elastance ◽  
Output State ◽  
Intra Aortic Balloon Counterpulsation ◽  
Balloon Counterpulsation

Intra-aortic balloon counterpulsation for acute decompensated heart failure

2014 ◽  
Vol 176 (3) ◽  
pp. 1444-1446 ◽  
Author(s):  
Masayuki Mizuno ◽  
Naoki Sato ◽  
Katsuya Kajimoto ◽  
Yasushi Sakata ◽  
Yuichiro Minami ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Intra Aortic Balloon Counterpulsation ◽  
Balloon Counterpulsation

Abstract 2097: Acute Ventricular Unloading in Dogs with Chronic Heart Failure: Comparison Between Intra-Aortic Balloon Counterpulsation and Continuous Aortic Flow Augmentation

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Mengjun Wang ◽  
Robert Brewer ◽  
Itamar Ilsar ◽  
Alice Jiang ◽  
Tony Viole ◽  
...  
Keyword(s):  
Heart Failure ◽  
Diastolic Pressure ◽  
Decompensated Heart Failure ◽  
Aortic Flow ◽  
Acute Therapy ◽  
Systolic Volume ◽  
End Diastolic Volume ◽  
End Systolic Volume ◽  
Intra Aortic Balloon Counterpulsation ◽  
Balloon Counterpulsation

Background: Continuous aortic flow augmentation (CAFA) therapy provided by the Cancion ® system (Orqis Medical, Inc.) for decompensated heart failure (HF)has been shown to effectively unload the left ventricle (LV) in dogs with chronic HF. In the present study, we compared the extent of acute LV unloading elicited by CAFA to that elicited by intra-aortic balloon counterpulsation (IABP) in normotensive dogs with HF produced by multiple sequential intracoronary microembolizations. Methods: Studies were performed in 6 dogs with HF. Each dog was studied with CAFA and with IABP. Studies were performed one week apart. For each study, therapy with CAFA or IABP was maintained for 4 hours. The Cancion system was positioned using a dual femoral approach configuration with constant pump flow of 250 ml/min thus superimposing an element of continuous flow on existing pulsatile aortic flow. In all dogs and with both devices, LV end-diastolic pressure (LVEDP), LV end-diastolic volume (EDV), LV end-systolic volume (ESV) and LV ejection fraction (EF) were measured at baseline prior to initiating therapy and were repeated at 2 hours and 4 hours after insituting CAFA or IABP. Results: Data (mean SEM) are shown in the table . Up to 4 hours of IABP had no significant effects on LVEDP, EDV, ESV or EF. In contrast, institution of CAFA for 4 hours significantly decreased LVEDP, EDV and ESV and significantly increased EF. Conclusions: In normotensive dogs with chronic HF and no epicardial coronary artery disease, acute therapy with IABP for up to 4 hours had no effect on LV unloading defined as a reduction in LV filling pressure and LV size. In the same cohort of dogs, CAFA therapy elicited marked LV unloading. These data indicate that CAFA is superior to IABP in achieving acute LV unloading in the setting of chronic HF not complicated by ongoing myocardial ischemia and/or cardiogenic shock.

Epinephrine for acute decompensated heart failure and low output state: Friend or foe?

2011 ◽  
Vol 149 (3) ◽  
pp. 384-385 ◽  
Author(s):  
Nuccia Morici ◽  
Alice Sacco ◽  
Fabrizio Oliva ◽  
Stefano Ferrari ◽  
Roberto Paino ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Output State

Assessing Acute Decompensated Heart Failure – Strategies and Tools

2012 ◽  
Vol 8 (2) ◽  
pp. 128
Author(s):  
Ali Vazir ◽  
Martin R Cowie ◽  
◽  
Keyword(s):  
Heart Failure ◽  
Acute Decompensated Heart Failure ◽  
Pulse Contour Analysis ◽  
Decompensated Heart Failure ◽  
Rapid Onset ◽  
Clinical Syndrome ◽  
Response To Therapy ◽  
Contour Analysis ◽  
Physiological Variables ◽  
Co Morbidity

Acute heart failure – the rapid onset of, or change in, signs and/or symptoms of heart failure requiring urgent treatment – is a serious clinical syndrome, associated with high mortality and healthcare costs. History, physical examination and early 2D and Doppler echocardiography are crucial to the proper assessment of patients, and will help determine the appropriate monitoring and management strategy. Most patients are elderly and have considerable co-morbidity. Clinical assessment is key to monitoring progress, but a number of clinical techniques – including simple Doppler and echocardiographic tools, pulse contour analysis and impedance cardiography – can help assess the response to therapy. A pulmonary artery catheter is not a routine monitoring tool, but can be very useful in patients with complex physiology, in those who fail to respond to therapy as would be anticipated, or in those being considered for mechanical intervention. As yet, the serial measurement of plasma natriuretic peptides is of limited value, but it does have a role in diagnosis and prognostication. Increasingly, the remote monitoring of physiological variables by completely implanted devices is possible, but the place of such technology in clinical practice is yet to be clearly established.

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