Mechanism of postextrasystolic potentiation in the right ventricle.
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 cineventriculographic 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).(ABSTRACT TRUNCATED AT 250 WORDS)
Department of Medicine, University of Texas Health Science Center, San Antonio.
L J
LJ
Dell'Italia
D006328:Cardiac Catheterization; D005117:Cardiac Complexes, Premature / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002932:Cineangiography; D003326:Coronary Circulation / Q000502:physiology; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology*; D013318:Stroke Volume / Q000502:physiology; D016276:Ventricular Function