Camus JM, Risk RM, Forteza E, Ramírez AJ, Cabrera FEI

Language: Spanish
References: 23
Page: 68-74
PDF size: 108.22 Kb.

ABSTRACT

Intra-aortic counterpulsation is a widely used circulatory support technique in patients with heart failure refractory to pharmacological treatment. This paper presents the effects of the autonomic nervous system activity on cardiovascular function during conventional intra-aortic counterpulsation in an animal model of acute heart failure. Recordings of 6 minutes of electrocardiographic, aortic pressure and pulmonary arterial flow signals were stored before and during mechanical circulatory assistance, before and after heart failure induction by a high dose of halothane. Heart rate, mean aortic pressure, mean pulmonary flow variability and baroreflex sensitivity were analyzed off-line, in both time and frequency domain. Non significant differences were caused by mechanical assistance by the intra-aortic counterpulsation, this lack of changes suggest that this technique is able to improve the hemodynamic changes induced by heart failure in sheep, without significant changes in aortic pressure and heart rate variability and baroreflex control.

REFERENCES

1. Lloyd-Jones DM, Larson MG, Leip EP, Beiser A, D’Agostino RB, Kannel WB et al. Lifetime risk for developing congestive heart failure. The Framingham heart study. Circulation 2002; 106: 3068-3072.

2. Khan MF, Risk MR. Cardiac variability and heart failure. In: Fischer EIC, editor. Cardiovascular failure. Pathophysiological bases and management. Fundación Universitaria Dr. René G. Favaloro, Buenos Aires, Argentina, 2001: 167-185.

3. Saul JP, Aray Y, Berger RD, Lilly LS, Colucci WS, Cohen RJ. Assessment of autonomic regulation in chronic congestive heart failure by heart rate spectral analysis. Am J Cardiol 1988; 61: 1292-1299.

4. Christen AI. Medical treatment of chronic heart failure. In: Fischer EIC, editor. Cardiovascular failure. Pathophysiological bases and management, Fundación Universitaria Dr. René G. Favaloro, Buenos Aires, Argentina, 2001: 207-245.

5. Jeevanandam V, Jayakar D, Anderson AS, Martin S, Piccione W, Heroux AL et al. Circulatory assistance with a permanent implantable IABP: initial human experience. Circulation 2002; 106: I183-I188.

6. Hunt SA, Baker DW, Chin MH, Cinquegrani MP, Feldman AM, Francis GS et al. ACC/AHA Guidelines for the evaluation and management of chronic heart failure in the adult: executive summary. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1995 Guidelines for the Evaluation and Management of Heart Failure). Circulation 2001; 104: 2996-3007.

7. Takeuchi M, Nohtomi Y, Yoshitani H, Miyasaka Ch, Sakamoto K, Yoshikawa J. Enhanced coronary flow velocity during intra-aortic balloon pumping assessed by transthoracic Doppler echocardiography. J Am Coll Cardiol 2004; 43: 368-376.

8. Kim SY, Euler DE, Jacobs WR, Montoya A, Sullivan HJ, Lonchyna VA et al. Arterial impedance in patients during intraaortic balloon counterpulsation. Ann Thorac Surg 1996; 61: 888-894.

9. Sands KEF, Appel ML, Lilly LS, Schoen FJ, Mudge GH, Cohen RJ. Power spectral analysis of heart rate variability in human cardiac transplant recipients. Circulation 1989; 79: 76-82.

10. Radaelli A, Valle F, Falcone C, Calciati A, Leuzzi S, Martinelli L et al. Determinants of heart rate variability in heart transplanted subjects during physical exercise. Eur Heart J 1996; 17: 462-471.

11. Risk MR, Ramírez A, Fischer EIC. Hemodynamic improvement and heart rate variability during aortic counterpulsation. Computers in Cardiology 2004; 31: 453-455.

12. Cabrera FEI, Chachques JC, García A, Pichel RH, Morales MC, Carpentier A. Temporary mechanical circulatory support for severe cardiac failure: experimental study. Int J Artif Organs 1991; 14: 466-472.

13. Risk MR, Sobh JF, Barbieri R, Saul JP. A Simple Algorithm for QRS Peak Location: Use On Long Term Recordings from the HMS-MIT-FFMS Database, IEEE Engineering in Medicine & Biology 17th Annual Conference; 1995.

14. Task Force of the European Society of Cardiology and the North American Society of Pacing Electrophysiology. Heart rate variability. Standards of measurement, physiological interpretation, and clinical use. Circulation 1996; 93: 1043-65.

15. Berger RD, Saul JP, Cohen R. Transfer function analysis of autonomic regulation. I Canine atrial rate response. Am J Physiol 1989; 256: H142-H152.

16. Saul JP, Berger RD, Chen MH, Cohen R. Transfer function analysis of autonomic regulation. II Respiratory sinus arrhythmia. Am J Physiol 1989; 256: H153-H161.

17. Saul JP, Berger RD, Albretch P, Stein SP, Chen MH, Cohen R. Transfer function analysis of the circulation: unique insights into cardiovascular regulation. Am J Physiol 1991; 261: H1231-H1245.

18. Ramírez A, Risk M. Variabilidad y control barorreflejo de la presión arterial. En: Ramos F, editor. El monitoreo ambulatorio de presión arterial. American Marketing & Communication SRL, Buenos Aires, Argentina; 1999: 153-165.

19. Cribari-Neto F, Zarkos SG. R: Yet another econometric programming environment. J Appl Econ 1999; 14: 319-329.

20. Cabrera FEI, de Forteza E, Risk M, Nicolini G, Camus JM, Pessana FM. Juxtaaortic counterpulsation: comparison with intraaortic counterpulsation in an animal model of acute heart failure. ASIO J 2004; 50: 311-315.

21. Saul JP. Heart rate variability during congestive heart failure: observations and implications. In: Di Rienzo, editor. Blood pressure and heart rate variability, IOS Press, Amsterdam, The Netherlands; 1992: 266-275.

22. Grassi G, Seravalle G, Cattaneo BM, Lanfranchi A, Vailati S, Giannasttasio C et al. Sympathetic activation and loss of reflex sympathetic control in mild congestive heart failure. Circulation 1995; 92: 3206-3211.

23. Bilchick KC, Fetics B, Djoukeng R, Fisher SG, Fletcher RD, Singh SN et al. Prognostic value of heart rate variability in chronic congestive heart failure (Veterans affairs’ survival trial of antiarrhythmic therapy in congestive heart failure). Am J Cardiol 2002; 90: 24-28.