Response of the left ventricle in idiopathic dilated cardiomyopathy to postextrasystolic potentiation

The effectiveness of postextrasystolic potentiation (PESP) was assessed to detect residual function of the left ventricle in seven patients with idiopathic dilated cardiomyopathy (IDC). The postextrasystolic changes in the aortic pressure pulse, global left ventricular function, and quantitative regional left ventricular wall motion were investigated. PESP caused an increase in the peak systolic aortic pressure (116 +/- 17 to 130 +/- 25 mm Hg, p less than 0.01), a decrease in the peak diastolic aortic pressure (74 +/- 12 to 61 +/- 11 mm Hg, p less than 0.001), a decrease in preejection period/left ventricular ejection time (PEP/LVET) ratio (0.637 +/- 0.136 to 0.457 +/- 0.097, p less than 0.001), and an increase in the global left ventricular ejection fraction (LVEF) (0.26 +/- 0.09 to 0.40 +/- 0.12, p less than 0.01). Postextrasystolic changes in LVEF were inversely related to changes in PEP/LVET (r = -0.76, p less than 0.05). The postextrasystolic patterns of the regional wall motion of the left ventricle were different in each patient. The results of this study suggest that residual left ventricular function can be detected in patients with IDC by their response to PESP.