Aortic Counterpulsation Therapy in Patients with Advanced Heart Failure: Analysis of the TBRIDGE Registry.
Arq Bras Cardiol
; 106(1): 26-32, 2016 Jan.
Article
em En, Pt
| MEDLINE
| ID: mdl-26690691
ABSTRACT
BACKGROUND:
The use of aortic counterpulsation therapy in advanced heart failure is controversial.OBJECTIVES:
To evaluate the hemodynamic and metabolic effects of intra-aortic balloon pump (IABP) and its impact on 30-day mortality in patients with heart failure.METHODS:
Historical prospective, unicentric study to evaluate all patients treated with IABP between August/2008 and July/2013, included in an institutional registry named TBRIDGE (The Brazilian Registry of Intra-aortic balloon pump in Decompensated heart failure - Global Evaluation). We analyzed changes in oxygen central venous saturation (ScvO2), arterial lactate, and use of vasoactive drugs at 48 hours after IABP insertion. The 30-day mortality was estimated by the Kaplan-Meier method and differences in subgroups were evaluated by the Log-rank test.RESULTS:
A total of 223 patients (mean age 49 ± 14 years) were included. Mean left ventricle ejection fraction was 24 ± 10%, and 30% of patients had Chagas disease. Compared with pre-IABP insertion, we observed an increase in ScvO2 (50.5% vs. 65.5%, p < 0.001) and use of nitroprusside (33.6% vs. 47.5%, p < 0.001), and a decrease in lactate levels (31.4 vs. 16.7 mg/dL, p < 0.001) and use of vasopressors (36.3% vs. 25.6%, p = 0.003) after IABP insertion. Thirty-day survival was 69%, with lower mortality in Chagas disease patients compared without the disease (p = 0.008).CONCLUSION:
After 48 hours of use, IABP promoted changes in the use of vasoactive drugs, improved tissue perfusion. Chagas etiology was associated with lower 30-day mortality. Aortic counterpulsation therapy is an effective method of circulatory support for patients waiting for heart transplantation.
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Insuficiência Cardíaca
/
Hemodinâmica
/
Balão Intra-Aórtico
Tipo de estudo:
Etiology_studies
/
Evaluation_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
America do sul
/
Brasil
Idioma:
En
/
Pt
Revista:
Arq Bras Cardiol
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
Brasil