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High-frequency High-resolution Echocardiography: First Evidence on Non-invasive Repeated Measure of Myocardial Strain, Contractility, and Mitral Regurgitation in the Ischemia-reperfused Murine Heart
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Diverging effects of postextrasystolic potentiation on left ventricular segmental wall motion in coronary heart

M Di Donato1, G A Barletta, M Maioli

  • 1Cattedra di Malattie dell' Apparato Cardiovascolare, University of Florence, Italy.

Clinical Cardiology
|October 1, 1987
PubMed

Insights

Postextrasystolic potentiation (PESP) improves regional left ventricular wall motion in coronary artery disease (CAD) patients. Most hypokinetic areas responded to PESP, showing its potential in assessing cardiac function in CAD.

Area of Science:

  • Cardiology
  • Cardiac Physiology
  • Diagnostic Imaging

Background:

  • Coronary artery disease (CAD) significantly impacts left ventricular (LV) function.
  • Assessing regional LV wall motion is crucial for diagnosing and managing CAD.
  • Postextrasystolic potentiation (PESP) is a phenomenon that can augment myocardial contractility.

Purpose of the Study:

  • To evaluate the effects of PESP on regional LV wall motion in patients with CAD.
  • To compare the response to PESP in different degrees of hypokinesis and in patients with and without prior myocardial infarction.
  • To determine the correlation between basal regional ejection fraction (EF) and PESP-induced changes in EF.

Main Methods:

  • PESP was induced by programmed atrial stimulation during LV angiography in 40 CAD patients and 8 normal subjects.
  • Regional LV wall motion was assessed by calculating regional ejection fraction (EF) in five areas.
  • Areas were classified by basal regional EF and categorized as 'responder' or 'nonresponder' based on PESP-induced EF increase.

Main Results:

  • A high percentage of normokinetic (68%), mildly hypokinetic (78%), severely hypokinetic (76%), and hyperkinetic (78%) areas responded to PESP.
  • While infarcted patients showed more hypokinetic areas at baseline, the response to PESP was similar to noninfarcted patients.
  • A strong positive correlation (r = 0.88) was observed between basal regional EF and post-PESP regional EF in CAD patients.

Conclusions:

  • PESP effectively enhances regional LV wall motion in various states of contractility in CAD patients.
  • The response to PESP is significant even in severely hypokinetic areas, suggesting its utility in evaluating myocardial function.
  • PESP provides valuable insights into regional LV mechanics and may serve as a useful tool in the assessment of CAD.

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