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. 2016 Jan;106(1):26-32.
doi: 10.5935/abc.20150147. Epub 2015 Dec 22.

Aortic Counterpulsation Therapy in Patients with Advanced Heart Failure: Analysis of the TBRIDGE Registry

[Article in English, Portuguese]
Cristiano Guedes Bezerra  1 , Eduardo Leal Adam  1 , Mariana Lins Baptista  1 , Giuliano Serafino Ciambelli  1 , Liliane Kopel  1 , Claudia Bernoche  1 , Leonardo Nicolau Geisler Daud Lopes  1 , Milena Frota Macatrão-Costa  1 , Breno de Alencar Araripe Falcão  1 , Silvia Gelas Lage  1
Affiliations

Aortic Counterpulsation Therapy in Patients with Advanced Heart Failure: Analysis of the TBRIDGE Registry

[Article in English, Portuguese]
Cristiano Guedes Bezerra et al. Arq Bras Cardiol. 2016 Jan.

Abstract

Background: The use of aortic counterpulsation therapy in advanced heart failure is controversial.

Objectives: To evaluate the hemodynamic and metabolic effects of intra-aortic balloon pump (IABP) and its impact on 30-day mortality in patients with heart failure.

Methods: Historical prospective, unicentric study to evaluate all patients treated with IABP between August/2008 and July/2013, included in an institutional registry named TBRIDGE (The Brazilian Registry of Intra-aortic balloon pump in Decompensated heart failure - Global Evaluation). We analyzed changes in oxygen central venous saturation (ScvO2), arterial lactate, and use of vasoactive drugs at 48 hours after IABP insertion. The 30-day mortality was estimated by the Kaplan-Meier method and differences in subgroups were evaluated by the Log-rank test.

Results: A total of 223 patients (mean age 49 ± 14 years) were included. Mean left ventricle ejection fraction was 24 ± 10%, and 30% of patients had Chagas disease. Compared with pre-IABP insertion, we observed an increase in ScvO2 (50.5% vs. 65.5%, p < 0.001) and use of nitroprusside (33.6% vs. 47.5%, p < 0.001), and a decrease in lactate levels (31.4 vs. 16.7 mg/dL, p < 0.001) and use of vasopressors (36.3% vs. 25.6%, p = 0.003) after IABP insertion. Thirty-day survival was 69%, with lower mortality in Chagas disease patients compared without the disease (p = 0.008).

Conclusion: After 48 hours of use, IABP promoted changes in the use of vasoactive drugs, improved tissue perfusion. Chagas etiology was associated with lower 30-day mortality. Aortic counterpulsation therapy is an effective method of circulatory support for patients waiting for heart transplantation.

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Conflict of interest statement

Potential Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1
Figure 1
Thirty-day survival curve.
Figure 2
Figure 2
Comparison of 30-day mortality between transplant patients (with Tx) and non-transplant patients (without Tx). n: number of patients at risk; 95%CI: 95% confidence interval. P-value was calculated using the Log-rank test: p < 0.001.
Figure 3
Figure 3
Comparison of 30-day mortality between patients with Chagas disease and other cardiomyopathies. n: number of patients at risk; 95% CI: 95% confidence interval. p value was calculated using the Log-rank test: p = 0.008.
See this image and copyright information in PMC

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