Document Detail


"Isolength" postextrasystolic potentiation as a predictor of functional restoration following surgical revascularization for myocardial ischemia.
MedLine Citation:
PMID:  2434239     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A previously developed method of programmed postextrasystolic potentiation (PESP) was assessed in eight patients with medically refractory unstable angina, as a predictor of functional restoration resulting from surgical revascularization. Prior to coronary arteriography, left ventricular segmental wall motion was determined during ventricular pacing and the first postextrasystolic beat following an extrasystole. The postextrasystole was induced at an interval calculated to occur at a time where ventricular preload was identical to the regular paced beat (isolength interval). The left ventricular wall was divided into six segments, each subscribing one area of the ventriculogram, and correction for rotation during systole was made. Of 48 segments, 21 were considered "jeopardized," due to greater than 70% reduction in cross-sectional lumen of the serving coronary arteries. Fifteen of these 21 responded to PESP, increasing their segmental area ejection fraction from 44 +/- 5 (paced "normal" beat) to 56 +/- 6 (postextrasystolic beat) (p less than 0.05). Following surgical revascularization, these segments showed an improvement in their baseline area ejection fraction from 44 +/- 6 to 58 +/- 5 (p less than 0.05). Six jeopardized segments that failed to respond to PESP prior to revascularization showed functional deterioration after revascularization. The 27 non-jeopardized segments (which were not revascularized) also showed functional improvement, suggesting improved collateral flow. This study demonstrates that isolength postextrasystolic potentiation obtained with a standardized pacing protocol may be used to predict the potential for improvement in cardiac function following surgical revascularization. Our results also show that lack of PESP predicts loss of left ventricular myocardial function following revascularization.
Authors:
M W Stanton; M W Cooper; J Voda; R Lust; L O Lutherer; M Feola
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular diagnosis     Volume:  12     ISSN:  0098-6569     ISO Abbreviation:  Cathet Cardiovasc Diagn     Publication Date:  1986  
Date Detail:
Created Date:  1987-04-10     Completed Date:  1987-04-10     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7508512     Medline TA:  Cathet Cardiovasc Diagn     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  381-5     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Angina Pectoris / surgery*
Angina, Unstable / surgery*
Cardiac Complexes, Premature / physiopathology*
Coronary Vessels / physiopathology
Female
Humans
Male
Middle Aged
Myocardial Contraction
Myocardial Revascularization*
Stroke Volume

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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