Primary intra-aortic balloon support versus inotropes for decompensated heart failure and low output: a randomised trial.
| Autor: | den Uil CA; Department of Cardiology, Thoraxcenter, Erasmus MC, University Medical Center, Rotterdam, the Netherlands., Van Mieghem NM, B Bastos M, Jewbali LS, Lenzen MJ, Engstrom AE, Bunge JJH, Brugts JJ, Manintveld OC, Daemen J, Wilschut JM, Zijlstra F, Constantinescu AA |
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| Jazyk: | angličtina |
| Zdroj: | EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology [EuroIntervention] 2019 Sep 20; Vol. 15 (7), pp. 586-593. |
| DOI: | 10.4244/EIJ-D-19-00254 |
| Abstrakt: | Aims: The haemodynamic effects of primary implantation of an intra-aortic balloon pump (IABP) versus inotropes in decompensated heart failure and low output (DHF-LO), but without an acute coronary syndrome, have not been investigated. We therefore aimed to investigate the effect of primary IABP implantation as compared to inotropes on haemodynamics in DHF-LO with no acute ischaemia. Methods and Results: Patients (n=32) with DHF-LO despite IV diuretics were randomised to primary 50 mL IABP or inotropes (INO: enoximone or dobutamine). The primary endpoint was the improvement of organ perfusion assessed by ∆ mixed-venous oxygen saturation (SvO2) at 3 hours; secondary endpoints included ∆ cardiac power output (CPO), NT-proBNP proportional change, cumulative fluid balance and ∆ dyspnoea severity score, all at 48 hours. Data are presented as median (IQR). Patients were 60 (48-69) years old and 72% were male. Baseline SvO2 was 44 (39-53)%. ∆SvO2 was higher in the IABP group (+17 [+9; +24] vs. +5 [+2; +9]%, p<0.05). IABP patients had a higher ∆CPO, a greater relative reduction in NT-proBNP, a more negative cumulative fluid balance, and a greater reduction in dyspnoea severity score. There were no IABP-related serious adverse events (SAEs). Thirty-day mortality was 23% (IABP) vs. 44% (INO). Conclusions: Primary circulatory support by IABP showed a significant increase in improved organ perfusion assessed by SvO2. |
| Databáze: | MEDLINE |
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