CARDIOVASCULAR ENGINEERING Journal for Extracorporeal Circulation, Assist Devices,Transplantation and Artificial Organs
	Volume 5, 2000, No 1

Heart Failure in Patients with Idiopathic Dilated Cardiomyopathy: Benefit of Intra-Aortic Balloon Counterpulsation
G. Tenderich, M. M. Koerner, N. zu Bentheim, A. El Banayosy, L. Kizner, L. Arusoglu, L. Hornik, S. Wlost, K. Minami, R. Koerfer

Objective(s): The objective of this study was to explain the positive response of patients with dilated cardiomyopathy to intra-aortic balloon counterpulsation, a phenomenon which can hardly be explained by the nutritional effect resulting from augmented coronary perfusion.

Design/Setting/Participants/Interventions: This retrospective single-center study included all transplant patients diagnosed for dilated cardiomyopathy and receiving intra-aortic balloon counterpulsation before heart transplantation or implantation of a permanent ventricular assist device within an 8-year period.

Measurements and Main Results: Intra-aortic balloon counterpulsation in patients diagnosed for dilated cardiomyopathy showed a significant drop in pulmonary capillary wedge pressure, as well as a significant increase in cardiac index and central venous oxygen saturation within three days after insertion of the balloon, whereas inotropic status was kept constant. In fact, the energy gained during diastole augmentation did not reach the level of energy gained by afterload reduction during deflation of the balloon - independently of the contractile status (sufficient/ insufficient) of the heart.

Conclusion: The coronary perfusion pressure, in the sense of a garden-hose effect, could be an explanation for hemodynamic improvement in these patients.

Key words: intra-aortic balloon counterpulsation (IABP), dilated cardiomyopathy (DCM), garden-hose effect, coronary perfusion pressure (CPP)

Address for Correspondence:
M. M. Koerner, M.D., Ph.D.
Heart Center Northrhine-Westphalia
University Hospital of the Ruhr-University of Bochum
Georgstr. 11
D-32545 Bad Oeynhausen
Germany

Reference:
(CVE. 2000; 5 (1): 16-18)

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