Abstract
Despite a fundamental difference in their underlying mechanisms, both postextrasystolic potentiation (PESP) and administration of nitroglycerin (TNG) have been utilized to predict reversibility of abnormal segmental wall motion in patients with ischemic heart disease. To determine whether these interventions induce the same changes in segmental contraction pattern, we analyzed biplane ventriculograms of 14 patients who had an adequately visualized PESP beat on a basal ventriculogram as well as a post-TNG ventriculogram. Four segments in each plane were defined and the area ejection fraction of each segment was calculated for a basal sinus, PESP, and post-TNG beat. To correct for global differences in the response to PESP and TNG, we normalized each segmental ejection fraction (NSEF) by the ventricular ejection fraction for that beat and then compared the differences in NSEF from the basal value after PESP and TNG. Eleven patients demonstrated similar responses to both interventions. The three patients whose responses were discordant had elevated or unchanged left ventricular systolic or end-diastolic pressures at the time of the TNG ventriculogram. Our data suggest that, provided these pressures are lower than basal values at t...Continue Reading
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