Document Detail

Clinical and hemodynamic characteristics of patients with inducible pulsus alternans.
MedLine Citation:
PMID:  3376843     Owner:  NLM     Status:  MEDLINE    
Pulsus alternans can be found in some patients with abnormal left ventricular function and also can develop after spontaneous premature beats. The purposes of this study were to: (1) determine the inducibility of pulsus alternans in a series of patients referred for routine cardiac catheterization and (2) define the clinical and hemodynamic characteristics of those who develop pulsus alternans. In 104 patients referred for right and left heart catheterization, atrial premature beats and rapid atrial pacing were used to try to provoke pulsus alternans. The 29 patients who developed pulsus alternans in response to these maneuvers were older (63 +/- 6 vs 59 +/- 10 years, p less than 0.01) and had a greater incidence of valvular heart disease (45% vs 23%, p less than 0.01) and congestive heart failure (38% vs 17%, p less than 0.05). Aortic stenosis was the most prevalent valve lesion found. Those who developed pulsus alternans in response to pacing were further characterized by higher left ventricular systolic (143 +/- 42 vs 121 +/- 23 mm Hg, p less than 0.02) and end-diastolic pressures (17 +/- 9 vs 13 +/- 6 mm Hg, p less than 0.05), higher pulmonary artery systolic pressure (35 +/- 14 vs 29 +/- 11 mm Hg, p less than 0.04), and lower left ventricular ejection fractions (0.42 +/- 0.13 vs 0.53 +/- 0.14, p less than 0.001). Eight patients (28%) with inducible pulsus alternans had a normal left ventricular ejection fraction (greater than 0.50) and left ventricular end-diastolic pressure (less than 13 mm Hg).(ABSTRACT TRUNCATED AT 250 WORDS)
S Schaefer; C R Malloy; J M Schmitz; G J Dehmer
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  115     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1988 Jun 
Date Detail:
Created Date:  1988-06-28     Completed Date:  1988-06-28     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1251-7     Citation Subset:  AIM; IM    
Cardiac Catheterization Laboratory, Dallas Veterans Administration Medical Center, TX 75216.
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MeSH Terms
Age Factors
Aortic Valve Stenosis / physiopathology
Blood Pressure
Cardiac Pacing, Artificial*
Heart Catheterization
Heart Failure / physiopathology
Heart Valve Diseases / physiopathology
Middle Aged
Stroke Volume

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