Research Article

Post-extrasystolic potentiation differentiates “true” from “pseudo” Low-flow, Low-gradient aortic stenosis

Marc Vanderheyden*, Sofie Verstreken and Marc Goethals

Published: 12/16/2020 | Volume 5 - Issue 3 | Pages: 172-173

Abstract

Post-extrasystolic potentiation (PESP) is a marker of contractile reserve and refers to the augmentation of left ventricular contractility due to preload recruitment and rise in intracellular calcium following a premature beat. In this case report we show that PESP might be a safe and helpful aid to evaluate low flow, low gradient aortic stenosis and contractile reserve in the cathlab, thereby reducing the potential risk of complications associated with intravenous dobutamine evaluation and reducing unnecessary testing.

Read Full Article HTML DOI: 10.29328/journal.jccm.1001105 Cite this Article

References

  1. Baumgartner H, Falk V, Bax JJ, De Bonis M, Hamm C, et al. 2017 ESC/EACTS Guidelines for the management of valvular heart disease. Eur Heart J. 2017; 38: 2739–2791. PubMed: https://pubmed.ncbi.nlm.nih.gov/28886619/  
  2. Wisenbaugh T, Nissen S, DeMaria A. Mechanics of postextrasystolic potentiation in normal subjects and patients with valvular heart disease. Circulation. 1986; 74: 10–20. PubMed: https://pubmed.ncbi.nlm.nih.gov/2423268/
  3. Domingo E, Angel J, Alvarez A, Anivarro I, Soler-Soler J. Postextrasystolic potentiation of systolic gradient in valvular aortic stenosis: Clinical usefulness and analysis of hemodynamic factors. Catheter Cardio Diag. 1987; 13: 381–390. PubMed: https://pubmed.ncbi.nlm.nih.gov/2446771/
  4. Wiley BM, Pollack A, Vaidya AS, Agarwal SK, Sengupta PP, et al. Post-Extrasystolic Transaortic Valve Gradients Differentiate “Pseudo” and “True” Low-Flow, Low-Gradient Severe AS During Dobutamine Stress Echocardiography. Jacc Cardiovasc Imaging. 2017; 10: 1199–1200. PubMed: https://pubmed.ncbi.nlm.nih.gov/28109925/
  5. Bhave NM, Patel AR, Shah AP, Lang RM. Postextrasystolic Potentiation in Low Gradient, Severe Aortic Stenosis: A Poor Man’s Stress Echo? Echocardiogr. 2013; 30: E148–151. PubMed: https://pubmed.ncbi.nlm.nih.gov/23551839/