Postextrasystolic potentiation: Regional wall motion before and after revascularization

Cooper, M W; Lutherer, L. O.; Stanton, Michael W; Lust, Robert M.

doi:10.1016/0002-8703(86)90150-x

Cited by 9 publications

(1 citation statement)

References 16 publications

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“…It has, therefore, been used to test myocardial viability and residual left ventricular function in patients with coronary artery disease (7,10,15,19), acute myocardial infarction (28), and idiopathic dilated cardiomyopathy (48).…”

Section: Calcium-kinetics In Reperfused Myocardiummentioning

confidence: 99%

Recruitment of a time-dependent inotropic reserve by postextrasystolic potentiation in normal and reperfused myocardium

Schäfer

Heusch

1990

Basic Res Cardiol

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Impaired excitation-contraction coupling has been suggested as the underlying mechanism of postischemic contractile dysfunction of reperfused myocardium in in-vitro studies. To test this hypothesis in situ, postextrasystolic potentiation (PESP) following an extrasystole with constant prematurity and three different postextrasystolic time intervals (compensated, regular, abbreviated) was analyzed in 12 anesthetized dogs. Changes in regional inotropic state were assessed by comparison of end-systolic wall thickness (sonomicrometry) during PESP to the respective pressure-matched values of an end-systolic pressure/wall-thickness relationship established during brief manual clamping of the aorta. Before ischemia, posterior end-systolic wall-thickness was increased by 0.19 +/- 0.35 (SD) mm during PESP with an abbreviated, by 0.36 +/- 0.42 mm with a regular, and by 0.60 +/- 0.42 mm with a compensated postextrasystolic interval. Baseline systolic wall thickening was decreased from 16.2 +/- 5.4% (before ischemia) to -3.0 +/- 3.4% at the end of 15 min left circumflex coronary occlusion, and to 2.8 +/- 7.5% at 10 min, 7.2 +/- 3.9% at 4 h, and 7.9 +/- 4.1% at 8 h reperfusion. Stepwise increases in regional inotropic state during PESP with increasing postextrasystolic intervals were not different in normal and reperfused myocardium. Thus, excitation-contraction coupling appears not to be impaired during inotropic stimulation of reperfused myocardium in situ.

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Section: Calcium-kinetics In Reperfused Myocardiummentioning

confidence: 99%

Recruitment of a time-dependent inotropic reserve by postextrasystolic potentiation in normal and reperfused myocardium

Schäfer

Heusch

1990

Basic Res Cardiol

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Electrocardiography and postextrasystolic potentiation: Utilization of the two methods to predict postrevascularization segmental myocardial function

Cooper

Mitchell

Lutherer

et al. 1991

Clinical Cardiology

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Suminury:We previously reported that postextrasystolic potentiation (PESP) is a useful predictor of changes in systolic wall function (SWF) following coronary revascularization. In the current study we analyzed ECG changes related to corresponding myocardial segments to determine their correlation with PESP and SWF. We found: ( 1) The PESP response in a jeopardized segment was ; 1 valid predictor of improved SWF even when Q wavcs. ST-segment changes, or T-wave changes were presenr. (2) However, when Q waves were present in two or niore of the corresponding leads, positive PESP was less likely to be observed. (3) Thus Q waves in two leads predicted the least postrevascularization improvement. (4) Segments with no corresponding Q-wave postrevascularization usually improved SWF. (5) Furthermore, a continuum o f responsiveness to PESP was found, ranging from T,-wavc changes. ST-segment changes to Q-wave changes. indicating dissociation between electrical and mechaiiical events. In conclusion, the ECG together with PESP provide good predictive infomiation relative to the efficacy of rcvascularization. PESP is a more valuable predictive indicator. ECG alone may be of value in that the occurrence of Q waves in two or more corresponding leads predicts a low probability of improved SWF. Further studies are indicated to investigate the dissociation betwcen electrical and mechanical events.

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Left Ventricular Function: Systolic and Diastolic Alterations

Krayenbuehl¹,

Jakob²,

Hess³

1994

Coronary Artery Graft Disease

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Postextrasystolic potentiation: Regional wall motion before and after revascularization

Cited by 9 publications

References 16 publications

Recruitment of a time-dependent inotropic reserve by postextrasystolic potentiation in normal and reperfused myocardium

Recruitment of a time-dependent inotropic reserve by postextrasystolic potentiation in normal and reperfused myocardium

Electrocardiography and postextrasystolic potentiation: Utilization of the two methods to predict postrevascularization segmental myocardial function

Left Ventricular Function: Systolic and Diastolic Alterations

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