Aortic Counterpulsation Therapy in Patients with Advanced Heart Failure: Analysis of the TBRIDGE Registry
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 pros...
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Cardiologia (SBC)
2016-01-01
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| Series: | Arquivos Brasileiros de Cardiologia |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2016000100026&lng=en&tlng=en |
| _version_ | 1811212673740701696 |
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| author | Cristiano Guedes Bezerra Eduardo Leal Adam Mariana Lins Baptista Giuliano Serafino Ciambelli Liliane Kopel Claudia Bernoche Leonardo Nicolau Geisler Daud Lopes Milena Frota Macatrão-Costa Breno de Alencar Araripe Falcão Silvia Gelas Lage |
| author_facet | Cristiano Guedes Bezerra Eduardo Leal Adam Mariana Lins Baptista Giuliano Serafino Ciambelli Liliane Kopel Claudia Bernoche Leonardo Nicolau Geisler Daud Lopes Milena Frota Macatrão-Costa Breno de Alencar Araripe Falcão Silvia Gelas Lage |
| author_sort | Cristiano Guedes Bezerra |
| collection | DOAJ |
| description | 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 betwen 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 diferences 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. |
| first_indexed | 2024-04-12T05:33:05Z |
| format | Article |
| id | doaj.art-2ace10a9d08e471fb9f1942a0db9a3bd |
| institution | Directory Open Access Journal |
| issn | 1678-4170 |
| language | English |
| last_indexed | 2024-04-12T05:33:05Z |
| publishDate | 2016-01-01 |
| publisher | Sociedade Brasileira de Cardiologia (SBC) |
| record_format | Article |
| series | Arquivos Brasileiros de Cardiologia |
| spelling | doaj.art-2ace10a9d08e471fb9f1942a0db9a3bd2022-12-22T03:45:57ZengSociedade Brasileira de Cardiologia (SBC)Arquivos Brasileiros de Cardiologia1678-41702016-01-011061263210.5935/abc.20150147S0066-782X2016000100026Aortic Counterpulsation Therapy in Patients with Advanced Heart Failure: Analysis of the TBRIDGE RegistryCristiano Guedes BezerraEduardo Leal AdamMariana Lins BaptistaGiuliano Serafino CiambelliLiliane KopelClaudia BernocheLeonardo Nicolau Geisler Daud LopesMilena Frota Macatrão-CostaBreno de Alencar Araripe FalcãoSilvia Gelas LageAbstract 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 betwen 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 diferences 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.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2016000100026&lng=en&tlng=enChoque Cardiogênico / mortalidadeInsuficiência CardíacaCardiomiopatia ChagásicaBalão Intra-AórticoTransplante de CoraçãoContrapulsação |
| spellingShingle | Cristiano Guedes Bezerra Eduardo Leal Adam Mariana Lins Baptista Giuliano Serafino Ciambelli Liliane Kopel Claudia Bernoche Leonardo Nicolau Geisler Daud Lopes Milena Frota Macatrão-Costa Breno de Alencar Araripe Falcão Silvia Gelas Lage Aortic Counterpulsation Therapy in Patients with Advanced Heart Failure: Analysis of the TBRIDGE Registry Arquivos Brasileiros de Cardiologia Choque Cardiogênico / mortalidade Insuficiência Cardíaca Cardiomiopatia Chagásica Balão Intra-Aórtico Transplante de Coração Contrapulsação |
| title | Aortic Counterpulsation Therapy in Patients with Advanced Heart Failure: Analysis of the TBRIDGE Registry |
| title_full | Aortic Counterpulsation Therapy in Patients with Advanced Heart Failure: Analysis of the TBRIDGE Registry |
| title_fullStr | Aortic Counterpulsation Therapy in Patients with Advanced Heart Failure: Analysis of the TBRIDGE Registry |
| title_full_unstemmed | Aortic Counterpulsation Therapy in Patients with Advanced Heart Failure: Analysis of the TBRIDGE Registry |
| title_short | Aortic Counterpulsation Therapy in Patients with Advanced Heart Failure: Analysis of the TBRIDGE Registry |
| title_sort | aortic counterpulsation therapy in patients with advanced heart failure analysis of the tbridge registry |
| topic | Choque Cardiogênico / mortalidade Insuficiência Cardíaca Cardiomiopatia Chagásica Balão Intra-Aórtico Transplante de Coração Contrapulsação |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2016000100026&lng=en&tlng=en |
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