Effect of balloon counterpulsation on myocardial ischemia as measured by intramyocardial carbon dioxide tension.

Ischemic injury of the heart following coronary artery occlusion is related to distribution of coronary blood flow and regional myocardial metabolic activity. Myocardial injury during regional ischemia has been studied by measuring tissue pCO2 with mass spectrometry, a parameter which reflects anaerobic cellular metabolism. Myocardial carbon dioxide tension has been used to evaluate the effect of unidirectional intra-aortic balloon pumping on ischemic injury resulting from acute coronary occlusion. In a group of ten dogs, balloon counterpulsation was begun immediately prior to left anterior descending coronary artery occlusion. A significant metabolic sparing effect was observed in counterpulsed dogs as compared to a control group. A decrease of 33% in PCO2 response was evident as compared to control. These results that early application of unidirectional intra-aortic balloon pumping may delay ischemic injury by improving regional oxygen supply/demand ratio to an area of acute ischemia.