Table 1.
Summary of trials on IABP use in Hypoperfused ADHF.
| Study | Study Type | Sample Size | Patient Characteristics | IABP Insertion/Duration |
Key Hemodynamic Measurements | Outcomes |
|---|---|---|---|---|---|---|
| Umakanthan et al. [24] | Retrospective | 18 | - End-stage HF - Failure/intolerance to inotropes |
Axillary, 27 ± 18 days | CI, CVP, mPAP, sPAP | * Recovery: 0%, HT: 72%, Death: 28% (6% despite LVAD), 1-month survival: 89%, 6-month survival: 72% |
| Mizuno et al. [25] | Prospective | 123 vs. 4678 | ADHF, modified Framingham HF criteria, IABP vs. no IABP | Femoral, n/a | N/A | Recovery: 71%, Death: 29% |
| Ntalianis et al. [26] | Prospective | 15 | End-stage HF, NYHA IV, INTERMACS 1-2, severe LV and RV systolic dysfunction | Femoral, 73 ± 50 days | CI, mPAP, PCWP, RAP, RVSWI, creatinine, bilirubin, LVEF, RVEDD | Recovery: 20%, LVAD: 40%, Death: 40% |
| den Uil et al. [27] | Retrospective | 27 | Inotrope-dependent HF, hypoperfusion, INTERMACS 1–2 | Femoral, median 4 days | MAP, RAP, SvcO2, fluid balance, sodium, serum lactate | Recovery: 26%, LVAD: 19%, Death: 26%, HT: 22%, 30 d survival: 67%, 1-year survival: 63% |
| Annamalai et al. [28] | Prospective | 10 | Stage D HF, NYHA III-IV, INTERMACS 2–3, low CO post-LVAD surgery | Femoral, <48 h | CPO, DPTI, LVESP, LVSW, PAP, PVR, myocardial oxygen supply/demand | LVAD: 100% |
| Hsu et al. [6] | Prospective | 74 | CS (89% HFrEF), SBP < 90 mm Hg, poor end-organ perfusion | Femoral, n/a |
CI, DBP, HR, LVCPI, PAP, PCWP, RAP, SBP, SVR | Recovery: 20%, LVAD: 45%, Death: 24%, HT: 8%, MCS: 4% |
| Morici et al. [29] | Prospective | 17 | Severe LV dysfunction, SBP < 90 mm Hg, MAP < 60 mm Hg, RAP > 12 mm Hg | Femoral, median 7 days | N/A | Recovery: 12%, LVAD: 53%, Death: 18%, HT: 12%, ECMO: 6% |
| Fried et al. [30] | Retrospective | 132 | ADHF with CS, CI < 2.2 L/min/m2, SBP < 90 mm Hg | Femoral (1 axillary), median 96 h | CI, CO, mPAP | Recovery: 16%, LVAD: 52%, Death: 18%, HT: 6%, 30 d survival: 84%, MCS: 8% |
| Imamura et al. [8] | Retrospective | 91 | Advanced worsening HF (69% on inotropes) | Subclavian, 25 ± 20 days | CI, CVP, PCWP, creatinine, serum lactate | Recovery: 12%, LVAD/HT: 69%, Death: 9%, MCS: 4% |
| Malick et al. [5] | Retrospective | 132 | ADHF with CS, CI < 2.2 L/min/m2, SBP < 90 mm Hg | Femoral, median 3 days | CI, CO, CPI, CPO, CVP, SVR, mPAP | Recovery: 16%, HT: 62%, Death: 22%, MCS: 8% |
| den Uil et al. [23] | Randomized | 32 | Diuretic-resistant ADHF, no ischemia, IABP vs. inotropes (enoximone/dobutamine) | Femoral, median 4 days | Greater 3 h SvO2 increase in IABP group | HT: 31% (IABP) vs. 0% (inotropes), 30 d mortality: 23% (IABP) vs. 44% (inotropes) |
Abbreviations: ADHF, Acute Decompensated Heart Failure; CI, Cardiac Index; CO, Cardiac Output; CPI, Cardiac Power Index; CPO, Cardiac Power Output; CS, Cardiogenic Shock; CVP, Central Venous Pressure; DBP, Diastolic Blood Pressure; DPTI, Diastolic Pressure–Time Index; ECMO, Extracorporeal Membrane Oxygenation; HF, Heart Failure; HFrEF, Heart Failure with Reduced Ejection Fraction; HT, Heart Transplant; IABP, Intra-Aortic Balloon Pump; INTERMACS, Interagency Registry for Mechanically Assisted Circulatory Support; LV, Left Ventricular; LVCPI, Left Ventricular Cardiac Power Index; LVEF, Left Ventricular Ejection Fraction; LVESP, Left Ventricular End-Systolic Pressure; LVSW, Left Ventricular Stroke Work; MAP, Mean Arterial Pressure; MCS, Mechanical Circulatory Support; mPAP, Mean Pulmonary Artery Pressure; N/A, Not available; NYHA, New York Heart Association; PAP, Pulmonary Arterial Pressure; PCWP, Pulmonary Capillary Wedge Pressure; PVR, Pulmonary Vascular Resistance; RAP, Right Atrial Pressure; RV, Right Ventricle; RVEDD, Right Ventricular End-Diastolic Diameter; RVSWI, Right Ventricular Stroke Work Index; SBP, Systolic Blood Pressure; sPAP, Systolic Pulmonary Artery Pressure; SVR, Systemic Vascular Resistance; SvcO2, Central Venous Oxygen Saturation; NTproBNP, N-terminal pro-B-type Natriuretic Peptide. * Recovery: correlated to the percentage of heart replacement therapies—free survival.