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Theoretical Establishment of a New Algorithm for Intra-Aortic Balloon Pumping for the Patients with Atrial Fibrillation, and Its Clinical Application.

房颤患者主动脉内球囊反搏新算法的理论建立及其临床应用。

基本信息

批准号：
63440051
负责人：
FUJIWARA Hitoshi
金额：
$ 2.62万
依托单位：
Tokyo Medical and Dental University
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (A)
财政年份：
1988
资助国家：
日本
起止时间：
1988 至 1989
项目状态：
已结题

项目摘要

In a case with atrial fibrillation, left ventricular(LV) end-diastolic volume is regulated by LV filling time (namely, preceding R-R interval on ECG). From this view point, we devised a new algorithm that the timing of IABP balloon inflation is decided by a regression equation between preceding R-R interval and interval of R-dicrotic notch in central aortic pressure, and compared the new algorithm with other five algorithms used in commercially available drivers.[Methods] on the basis of secondary regression equations which were analyzed and established statistical goodness of fit in the 1st year of this research project, we tested this new algorithm using the ECG and central aortic pressure waves recorded simultaneously from the patients with atrial fibrillation who had undergone cardiac operation and applied intra-aortic balloon pumping immediately after the surgery. Finally, we invented a new driver for intra-aortic balloon pumping, in which the secondary regression equation between … More preceding R-R interval and R-dicrotic notch interval is calculated automatically during the periodical short stop of the intra-aortic balloon pumping and the optimal timing of balloon inflation is readjust using newly calculated equation.[Results] The secondary equations were revealed statistical significance and good fitness but the relationship between these parameters became liner in the R-R interval longer than 900 mesc. and the decisive coefficient value were distributed from 0.6 to 0.75. In the comparative study of this new algorithm with the algorithms used in commercially available drivers, the new algorithm showed most optimal timing and the standard deviation(S.D.) of timing difference between the best inflation timing (aortic dicrotic notch) and the true timing of this new algorithm showed smallest value with statistical significance compared with other five drivers. The S.D. value in new algorithm was 8.50 msec., Kontron K-2000, which had most excellent response to atrial fibrillation, showed 14.89 msec. and AVCO model-10, which had ineffective algorithm, 54.44 msec. Lastly, we made a new driver regulated by this new optimal algorithm for the patients with atrial fibrillation and applied clinically with marked hemodynamic improvements. Less

在房颤病例中，左心室（LV）舒张末期容积由LV充盈时间（即ECG上的前一个R-R间期）调节。从这个角度出发，我们设计了一种新的算法，即IABP球囊充气的时间由先前的R-R间期与中心主动脉压的R-重搏切迹间期之间的回归方程决定，并将新算法与市售驱动器中使用的其他五种算法进行了比较。[方法]在本研究项目第一年分析并建立统计学拟合优度的二次回归方程的基础上，使用同时记录的接受心脏手术并应用主动脉内球囊反搏的房颤患者的心电图和中心主动脉压力波来测试这种新算法。手术后立即。最后，我们发明了一种用于主动脉内球囊反搏的新驱动器，其中， ...更多信息在主动脉内球囊反搏周期性短暂停止期间，自动计算先前的R-R间期和R-重搏切迹间期，并使用新计算的公式重新调整球囊充气的最佳时机。[结果]二级方程具有统计学意义，拟合效果较好，但在大于900 mesc的R-R间期内，各参数之间的关系趋于线性。决定系数值分布在0.6 ~ 0.75之间。在与商用驱动程序中使用的算法的比较研究中，新算法显示出最优定时和标准偏差（S.D.）最佳充盈时机（主动脉重搏切迹）与真实时机之间的时间差与其他五种驱动器相比，新算法显示最小值，具有统计学意义。保安处新算法中的值为8.50毫秒，Kontron K-2000对房颤的反应最好，为14.89 msec。AVCO model-10算法无效，为54.44 msec。最后，我们为房颤患者制作了一个新的驱动器，并将其应用于临床，血流动力学得到了明显改善。少