Predictors of Hemodynamic Response to Intra-Aortic Balloon Pump Therapy in Patients With Acute Decompensated Heart Failure and Cardiogenic Shock

Athena L. Huang, Justin A. Fried, Waqas Malick, Veli Topkara, Ersilia M. DeFilippis, Jennifer Haythe, Maryjane Farr, Melana Yuzefpolskaya, Paolo C. Colombo, Koji Takeda, E. Wilson Grandin, Ajay J. Kirtane, Duane Pinto, A. Reshad Garan

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

OBJECTIVES: There is renewed interest in intra-aortic balloon pump (IABP) use in chronic systolic heart failure (HF) patients with acute decompensation and cardiogenic shock (CS). We sought to identify predictors of early IABP response to guide optimal use in this population. METHODS: We retrospectively analyzed records of chronic systolic HF patients presenting to our center between 2011-2018 with acute decompensated HF who received IABP for CS. An IABP responder was defined as having both an early cardiac output (CO) increase and mean pulmonary artery pressure (MPAP) decrease above the cohort median values. RESULTS: During this period, a total of 218 chronic systolic HF patients received IABP for acute decompensation with CS. The average CO increase was 0.57 ± 0.85 L/min and MPAP reduction was 5.1 ± 7.6 mm Hg. Fifty-six patients (25.7%) were identified as IABP responders, with mean CO increase of 1.21 ± 0.87 L/min and MPAP reduction of 12.1 ± 5.9 mm Hg. Systemic vascular resistance (SVR) >1300 dynes/sec/cm-5 (odds ratio [OR], 5.04; 95% confidence interval [CI], 1.86-13.6; P<.01) and moderate-severe mitral regurgitation (OR, 2.42; 95% CI, 1.25-4.66; P<.01) predicted robust hemodynamic response. CONCLUSIONS: A subset of chronic systolic HF patients had robust hemodynamic response to IABP with significant CO augmentation and MPAP reduction. Higher SVR and moderate-severe mitral regurgitation predicted early hemodynamic response to IABP.

Original languageEnglish (US)
Pages (from-to)E275-E280
JournalThe Journal of invasive cardiology
Volume33
Issue number4
StatePublished - Apr 1 2021
Externally publishedYes

Keywords

  • cardiogenic shock
  • heart failure
  • intra-aortic balloon pump
  • mechanical circulatory support

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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