title: Heart rate effect on hemodynamics during mechanical assistance by the intra-aortic balloon pump.
abstract: Heart rate (HR) has been characterized as an important cardiovascular parameter that affects acute hemodynamic performance of intra-aortic balloon counterpulsation (IABC). However, the effect of HR on hemodynamics during mechanical assistance by the IABC has neither been clarified nor quantified. We sought to evaluate the relationship between IABC and HR and also to examine whether there is a range of HR with optimum hemodynamic response to IABC.
  
  
  METHODS
  20 patients (14 males--6 females, mean age 64.4 +/- 11.4 years) with post-infarction cardiogenic shock undergoing IABC treatment were evaluated. Hemodynamics were recorded for each patient once per day during the assistance period; 131 measurements were taken and thus a wide range of heart rates was obtained (64-141 bpm). The following changes in aortic pressures were used to evaluate acute IABC performance on: a) the maximal increase of diastolic aortic pressure induced by IABC and b) the reduction in systolic and end-diastolic aortic pressure.
  
  
  RESULTS
  Non-linear regression analysis and analysis of variance revealed that a significant correlation exists between IABC performance indices and heart rate. At HR<80 bpm, IABC performance tended to be reduced, whereas the increase in HR above 110 bpm resulted in a significant reduction of all IABC performance indices. In contrast, IABC operating at 80-110 bpm resulted in optimum hemodynamic performance. In conclusion, the effect of heart rate on IABC performance is non-linear indicating that IABC may be more effective when operating within 80-110 bpm.
authors.affiliation: Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodestrian University of Athens, Athens, Greece. theopap@central.ntua.gr
authors.forename: T G
authors.initials: TG
authors.lastname: Papaioannou
authors.forename: J
authors.initials: J
authors.lastname: Terrovitis
authors.forename: J
authors.initials: J
authors.lastname: Kanakakis
authors.forename: K S
authors.initials: KS
authors.lastname: Stamatelopoulos
authors.forename: A D
authors.initials: AD
authors.lastname: Protogerou
authors.forename: J P
authors.initials: JP
authors.lastname: Lekakis
authors.forename: J N
authors.initials: JN
authors.lastname: Nanas
authors.forename: S F
authors.initials: SF
authors.lastname: Stamatelopoulos
mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000503:physiopathology*; D012044:Regression Analysis; D012770:Shock, Cardiogenic / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy*; D016896:Treatment Outcome