Influence of intraaortic balloon pump counterpulsation on transesophageal echocardiography derived determinants of diastolic function
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Updated: Apr 16, 2026
Noninvasive Determination of Vortex Formation Time Using Transesophageal Echocardiography During Cardiac Surgery
Published on: November 28, 2018
Martina Nowak-Machen1, Jan N Hilberath2, Peter Rosenberger1
1Klinik für Anaesthesiologie und Intensivmedizin, Universitätsklinikum Tübingen, Germany.
Insights
Intra-aortic balloon pump counterpulsation (IABP) improves diastolic function in cardiac surgery patients. This study shows IABP favorably impacts left ventricular relaxation, a crucial factor in patient recovery.
Area of Science:
- Cardiology
- Cardiac Surgery
- Echocardiography
Background:
- Intra-aortic balloon pump counterpulsation (IABP) is utilized for acute coronary syndrome, primarily for systolic function and coronary perfusion.
- The impact of IABP on left ventricular (LV) diastolic function remains less understood, despite its association with morbidity and mortality.
- This study investigates IABP's effects on LV diastolic dysfunction using transesophageal echocardiography (TEE).
Purpose of the Study:
- To evaluate the influence of IABP on left ventricular diastolic dysfunction.
- To assess changes in standard TEE-derived diastolic function parameters with IABP use.
Main Methods:
- Ten patients undergoing urgent coronary artery bypass graft (CABG) surgery with preoperative IABP were studied.
- Intraoperative TEE assessed diastolic function using parameters like E/A ratio, deceleration time (Dt), pulmonary venous flow (S/D), transmitral propagation velocity (Vp), and mitral annular velocities (e'/a').
- Statistical analysis involved the Wilcoxon Sign-Rank test, with p<0.05 considered significant.
Main Results:
- IABP significantly increased E/A ratios (0.86 to 1.07) and Vp (34 to 43 cm/s).
- IABP significantly decreased deceleration time (218 to 180 ms) and increased e'/a' (0.58 to 0.71).
- These changes indicate a favorable impact on LV diastolic function.
Conclusions:
- Perioperative IABP use significantly enhances TEE-derived diastolic function parameters.
- IABP demonstrates a favorable effect on left ventricular relaxation in patients undergoing CABG.
- The findings support IABP's role in improving diastolic function during cardiac surgery.
Introduction:
Intraaortic balloon pump counterpulsation (IABP) is often used in patients with acute coronary syndrome for its favourable effects on left ventricular (LV) systolic function and coronary perfusion. However, the effects of IABP on LV diastolic function have not been comprehensively investigated. Acute diastolic dysfunction has been linked to increased morbidity and mortality. The aim of this study was to examine the influence of IABP on LV diastolic dysfunction using standard TEE derived parameters.
Methods:
Intraoperative TEE was performed in 10 patients (mean age 65 ± 11 yrs) undergoing urgent coronary artery bypass graft surgery (CABG), who had received an IABP preoperatively. TEE derived measures of diastolic dysfunction included early to late transmitral Doppler inflow velocity ratio (E/A), deceleration time (Dt), pulmonary venous systolic to diastolic Doppler velocity ratio (S/D), transmitral propagation velocity (Vp), and the ratio of early to late mitral annular tissue Doppler velocities (e'/a'). Statistical analyses included the Wilcoxon Sign-Rank test, and a p<0.05 was considered significant.
Results:
Transmitral inflow E/A ratios increased significantly from 0.86 to 1.07 (p < 0.05), while Dt decreased significantly from 218 to 180 ms (p < 0.05) with the use of IABP. Significant increases in Vp (34 cm/s to 43 cm/s; p < 0.05), and e'/a' (0.58 to 0.71; p < 0.05) suggested a favourable influence of intraaortic counterpulsation on diastolic function.
Conclusion:
The use of perioperative IABP significantly improves TEE derived parameters of diastolic function consistent with a favourable impact on LV relaxation in cardiac surgery patients undergoing CABG.
