Azevedo Clerio F, Amado Luciano C, Kraitchman Dara L, Gerber Bernhard L, Edvardsen Thor, Osman Nael F, Rochitte Carlos E, Wu Katherine C, Lima Joao A C
Department of Medicine, Division of Cardiology, Johns Hopkins Hospital, 600 N. Wolfe Street, Baltimore, MD 21287-0409, USA.
Eur Heart J. 2005 Jun;26(12):1235-41. doi: 10.1093/eurheartj/ehi137. Epub 2005 Feb 16.
We sought to determine whether intra-aortic balloon pump (IABP) counterpulsation improves the recovery of left ventricular (LV) systolic function after reperfused acute myocardial infarction (AMI).
Fourteen dogs underwent 90-min coronary artery occlusion followed by reperfusion. Seven animals were randomized to IABP counterpulsation immediately after reperfusion. Tagged, cine, and contrast-enhanced magnetic resonance imaging were used for regional and global LV functional assessment and MI characterization, respectively. Image acquisition was performed at 1 h, 6 h, and 24 h after reperfusion, during which the IABP device was paused. Animals randomized to IABP demonstrated an earlier improvement of LV ejection fraction when compared with controls (25+/-3 vs. 25+/-2% at 1 h, P=0.91; 36+/-3 vs. 26+/-2% at 6 h, P=0.015; and 38+/-3 vs. 35+/-1% at 24 h, P=0.34). Regional functional analyses revealed the same behaviour among non-infarcted risk regions, i.e., earlier circumferential systolic strain improvement in the IABP group than in controls (-5.4+/-0.4 vs. -5.3+/-0.5% at 1 h, P=0.86; -12.1+/-1.0 vs. -6.0+/-0.4% at 6 h, P<0.001; and -13.9+/-1.1% vs. -12.8+/-0.6% at 24 h, P=0.40). Importantly, however, the degree of LV functional recovery 24 h after reperfusion was similar whether IABP counterpulsation was used or not.
IABP counterpulsation accelerates but does not significantly improve the recovery of LV systolic function after reperfused AMI.
我们试图确定主动脉内球囊反搏（IABP）能否改善再灌注急性心肌梗死（AMI）后左心室（LV）收缩功能的恢复。
14只犬接受90分钟冠状动脉闭塞后再灌注。7只动物在再灌注后立即随机接受IABP反搏。标记磁共振成像、电影磁共振成像和对比增强磁共振成像分别用于局部和整体左心室功能评估以及心肌梗死特征分析。在再灌注后1小时、6小时和24小时进行图像采集，在此期间IABP装置暂停。与对照组相比，随机接受IABP的动物左心室射血分数改善更早（1小时时分别为25±3%和25±2%，P = 0.91；6小时时分别为36±3%和26±2%，P = 0.015；24小时时分别为38±3%和35±1%，P = 0.34）。局部功能分析显示，在非梗死风险区域也有相同表现，即IABP组的圆周收缩应变改善比对照组更早（1小时时分别为-5.4±0.4%和-5.3±0.5%，P = 0.86；6小时时分别为-12.1±1.0%和-6.0±0.4%，P<0.001；24小时时分别为-13.9±？1.1%和-12.8±0.6%，P = 0.40）。然而，重要的是，无论是否使用IABP反搏，再灌注后24小时左心室功能恢复程度相似。
IABP反搏可加速再灌注AMI后左心室收缩功能的恢复，但不能显著改善。 （注：原文中“-13.9±？1.1%”这里的问号是原文的不清晰，我按原样保留了。）
