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Postextrasystolic potentiation in man.

T der Werf, R van Poelgeest, H H Herbschleb

    European Journal of Cardiology
    |May 1, 1976
    PubMed
    Summary
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    Postextrasystolic potentiation (PESP) quantifies left ventricular (LV) contractility. This study shows PESP increases with extrasystolic prematurity, offering a reproducible method for LV contractility estimation in humans.

    Area of Science:

    • Cardiology
    • Physiology

    Background:

    • Postextrasystolic potentiation (PESP) is a myocardial property independent of pre- and afterload.
    • PESP has been utilized to assess left ventricular (LV) contractile state in patients with coronary heart disease and healthy individuals.

    Purpose of the Study:

    • To evaluate the quantitative and reproducible assessment of LV contractility using PESP.
    • To investigate the relationship between extrasystolic prematurity and PESP indices.

    Main Methods:

    • A computer-controlled cardiac stimulator was used to apply regular rhythms, interrupted by premature stimuli.
    • Left ventricular pressures were analyzed using a catheter-tip manometer.
    • Indices of LV contractile state, including peak dP/dt, time to peak dP/dt, (dP/dt)/P at 50 mm Hg, and Vmax, were measured.

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    Main Results:

    • Increasing prematurity of the extrasystolic beat led to a progressive and reproducible increase in LV contractile indices.
    • No significant PESP was observed in patients with significantly enlarged LV volumes and reduced ejection fractions when using Vmax.
    • End-diastolic pressure showed no significant difference between pre- and post-extrasystolic beats.

    Conclusions:

    • PESP, elicited under controlled conditions, provides an integral, quantitative, and reproducible method for estimating LV contractility in humans.
    • The method's efficacy may be limited in patients with severely depressed LV function and enlarged volumes.