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Intra-aortic balloon pumping reduces the increased arterial load caused by acute cardiac depression, modifying central and peripheral load determinants in a time- and flow-related way

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Abstract

The mechanisms that explain intra-aortic balloon pumping (IABP) effects are not completely understood, and attributing them only to pressure-associated changes in cardiac function would be an oversimplification. Since IABP modifies the aortic and systemic blood-flow pattern, flow-related effects could be expected. To characterize effects of acute heart failure (AHF) on the arterial biomechanics; IABP effects on the arterial biomechanics during AHF, and their potential time-dependence; the association between hemodynamics and biomechanical changes during AHF and IABP. Sheep (n = 6) aortic pressure, flow, and diameter were measured: (1) before (Basal) and (2) 1–3 (HF1–3) and 28–30 (HF28–30) min after starting halothane to induce AHF; and (3) at specific times (1–3, 14–15 and 28–30 min) during IABP assistance. Calculus: aortic characteristic impedance (Z c), beta stiffness (β), incremental (E INC) and pressure–strain elastic modulus (E P); total arterial compliance (C G), total systemic vascular resistance and wave propagation parameters. (1) AHF resulted in an acute increase in aortic and systemic stiffness (HF28–30 % changes with respect to Basal conditions: β +217%, E P +143%, E INC +101%, Z c +52%, C G −13%), associated with the reduction in the aortic blood flow; (2) during AHF IABP resulted in acute beneficial changes aortic and systemic biomechanics (% changes in IABP1–3 with respect HF28–30: β −62%, E P −68%, E INC −66%, Z c −38%, C G 66%), and in wave propagation parameters, (3) IABP-related changes were time-dependent and associated with changes in aortic blood flow. Aortic and systemic biomechanical and impedance properties are detrimentally modified during AHF, being the changes rapidly reverted during IABP. IABP-related beneficial changes in arterial biomechanics were time-dependent and associated with IABP capability to increase blood flow.

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Acknowledgments

This work was supported by the Favaloro University (Argentina), the Agencia Nacional de Investigación e Innovación (ANII; Grants: FCE-2007-635 and FCE-2007-638; Uruguay) and PEDECIBA-Biología (Uruguay).

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Authors and Affiliations

  1. Cardiovascular Haemodynamic Group, Physiology Department, School of Medicine, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Republic University, General Flores 2125, 11800, Montevideo, Uruguay

    Daniel Bia, Yanina Zócalo & Ricardo L. Armentano

  2. Favaloro University, Buenos Aires, Argentina

    Edmundo I. Cabrera-Fischer & Ricardo L. Armentano

  3. CONICET, Buenos Aires, Argentina

    Edmundo I. Cabrera-Fischer

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  1. Daniel Bia
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  2. Edmundo I. Cabrera-Fischer
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  3. Yanina Zócalo
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  4. Ricardo L. Armentano
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Correspondence to Daniel Bia.

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Bia, D., Cabrera-Fischer, E.I., Zócalo, Y. et al. Intra-aortic balloon pumping reduces the increased arterial load caused by acute cardiac depression, modifying central and peripheral load determinants in a time- and flow-related way. Heart Vessels 27, 517–527 (2012). https://doi.org/10.1007/s00380-011-0203-8

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