Mechanism of postextrasystolic potentiation in the right ventricle


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    • Author:  Dell'Italia LJ.  

    • Abstract:  Mechanism of postextrasystolic potentiation in the right ventricle. Dell'Ita lia LJ. Department of Medicine, University of Texas Health Science Center, San Antonio. The mechanism of postextrasystolic potentiation (PESP) has been studied in the left ventricle in humans; however, this phenomenon has not been evaluated in the right ventricle. Accordingly, 18 sinus beats were compared to postextrasystolic beats during the same cineventriculogram using simultaneous high-fidelity right ventricular (RV) and pulmonary artery pressures and cast-validated biplane cineventriculographi c volumes in normal patients. The increase in cycle length was 22 +/- 12% (standard deviation) in the postextrasystolic beats. Right ventricular ejection fraction increased from 61 +/- 10 to 68 +/- 4% (p less than 0.001) and RV stroke volume increased from 99 +/- 18 to 128 +/- 20 ml (p less than 0.001) due to an increase in RV end-diastolic volume (165 +/- 34 to 189 +/- 30 ml, p less than 0.001) as RV end-systolic volume (65 +/- 24 to 61 +/- 17 ml, difference not significant) and RV end-systolic pressure (16 +/- 7 to 17 +/- 6 mm Hg, difference not significant) remained unchanged. Despite an increase in RV systolic pressure from 29 +/- 7 to 31 +/- 7 mm Hg (p less than 0.01) and an increase in RV end-diastolic pressure from 8 +/- 4 to 10 +/- 5 mm Hg (p less than 0.001), RV +dP/dtmax did not change (318 +/- 102 to 294 +/- 82 mm Hg/s, difference not significant).(ABSTRA CT TRUNCATED AT 250 WORDS) PMID: 1690502 [PubMed - indexed for MEDLINE]

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