21 A comparison of coronary haemodynamics in 40cc versus 50cc intra-aortic balloon pumps
Notice bibliographique
Résumé
Introduction Randomised trials have questioned the benefit of intra-aortic balloon pump (IABP) counterpulsation in high-risk PCI and shock. A larger capacity balloon has been introduced into routine clinical practice that has been shown to provide greater systolic unloading and diastolic augmentation compared with the standard balloon. Our aim was to investigate whether larger capacity balloons provide a greater augmentation in coronary flow compared with standard capacity balloons. Methods Seven patients with severe ischaemic cardiomyopathy were studied using a two-treatment, single sequence crossover protocol at the time of elective percutaneous coronary intervention (PCI). Simultaneous coronary pressure and Doppler measurements were undertaken in the target vessel after PCI using a Volcano Combowire, during unassisted and assisted IABP conditions, first with a 40cc IABP and then, five minutes later, with a 50cc IABP. Measurements were taken with intact autoregulation and with autoregulation temporarily disabled by administration of intracoronary adenosine. Coronary wave intensity analysis was performed to characterise the wave energies associated with balloon counterpulsation. Data are presented as mean ± SD. Results Patients were 65 (±12) years old (75% male). Left ventricular ejection fraction was 29% (±11%) with a coronary jeopardy score of 11 (±2) (maximum possible score=12). There was no difference between the 40cc and 50cc IABP balloons in average peak velocity (50.3±33.6 vs. 49.7±24.2 cm s −1 p=0.916), mean distal coronary pressure (83.4±16 vs. 85.2±20 mmHg, p=0.549) (see Figure 1), or microvascular resistance (181.6±52.9 vs. 207.5±83.4 mmHgcm −1 s, p=0.218) when autoregulation was disabled. Results were similar during basal assisted conditions. On wave intensity analysis, a late diastolic forward compression wave was identified during IABP support that was not seen during unassisted conditions. The magnitude of the IABP-forward compression wave was numerically greater with the 50cc balloon during basal conditions, which did not reach statistical significance (1.7±1.7 vs. 2.8±3.1, W m −2 s −2 × 10 5 , p=0.155) (see Figure 2). Conclusions The larger capacity balloon does not provide greater augmentation in coronary flow or reduction in microvascular resistance compared with the standard balloon during basal or hyperaemic conditions. We did not measure left ventricular afterload or myocardial oxygen demand in this study and cannot exclude a differential effect of the 50cc balloon on myocardial oxygen supply and demand. Abstract 21 Figure 1 Box plots demonstrating effects of 40cc and 50cc balloons on average peak velocity (A) and mean distal coronary pressure (B). Abstract 21 Figure 2 (A) Wave Intensity Profile during intra-aortic balloon pump assisted conditions, highlighting the temporally related wave energies with device inflation (IABP-FCW) and deflation (IABP-FEW). FCW=forward compression wave; BCW= backward compression wave; FEW=forward expansion wave, BEW= backward expansion wave. (B) Box plot demonstrating effects of 40cc and 50cc balloons on IABP-FCW during basal conditions.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».