Davies Andrew N, Peters William S, Su Tonglin, Sullivan Colin E, Perkidides Theo, Milsom F Paget, White Geoffrey
School of Human Life Sciences, The University of Tasmania, Locked Bag 1320, Launceston, Tasmania 7250, Australia.
Heart Lung Circ. 2005 Sep;14(3):178-86. doi: 10.1016/j.hlc.2005.03.018. Epub 2005 Jul 25.
Diastolic counterpulsation has been used to provide circulatory augmentation for chronic heart failure or for short-term cardiac support. Recently an extra-aortic balloon (EAB) counterpulsation device has been proposed.
To compare the circulatory effects of counterpulsation using the EAB or an intra-aortic balloon (IAB) in the acute pig model.
In six anaesthetized great white pigs (paced at 100 bpm), ECG, arterial and central venous pressures, flow in the coronary circulation and descending thoracic aorta were measured. Baseline data was collected, then with the EAB or an IAB fitted using 1:1 and 1:2 counterpulsation modes. Baseline data was compared to EAB and IAB data in 1:1 mode. Assisted beat data compared to unassisted beat data was also analysed in 1:2 mode.
Both devices augmented peak diastolic arterial pressure, and decreased afterload. EAB counterpulsation increased diastolic coronary flow in both the 1:1 mode by 69% (p < 0.05) and in the 1:2 mode by 63% (assisted versus unassisted beat, p < 0.05). The IAB significantly increased diastolic coronary flow only in the 1:2 mode by 28% (p < 0.01). Both devices augmented total coronary flow and some augmentation of aortic flow was observed.
The circulatory effect of the EAB and IAB counterpulsation were comparable. This suggests the EAB could be used as a non-blood contacting heart assist device in patients suffering moderate-severe heart failure.
舒张期反搏已被用于为慢性心力衰竭或短期心脏支持提供循环增强。最近，一种主动脉外球囊（EAB）反搏装置被提出。
在急性猪模型中比较使用EAB或主动脉内球囊（IAB）进行反搏的循环效应。
对六只麻醉的大白猪（以100次/分钟起搏），测量心电图、动脉压和中心静脉压、冠状动脉循环和胸主动脉降部的血流。收集基线数据，然后使用1:1和1:2反搏模式安装EAB或IAB。将基线数据与1:1模式下的EAB和IAB数据进行比较。在1:2模式下，还分析了辅助搏动数据与非辅助搏动数据的比较。
两种装置均增加了舒张期动脉压峰值，并降低了后负荷。EAB反搏在1:1模式下使舒张期冠状动脉血流增加69%（p<0.05），在1:2模式下增加63%（辅助搏动与非辅助搏动相比，p<0.05）。IAB仅在1:2模式下使舒张期冠状动脉血流显著增加28%（p<0.01）。两种装置均增加了冠状动脉总血流，并观察到主动脉血流有一定增加。
EAB和IAB反搏的循环效应相当。这表明EAB可作为中重度心力衰竭患者的非血接触式心脏辅助装置。
