Age-related decline in postextrasystolic potentiation in patients with aortic stenosis

In aortic stenosis (AS), postextrasystolic potentiation (PESP), a measure of contractile reserve, has been demonstrated by an increased aortic valve gradient (AVG) after a ventricular extrasystole (VE). We studied age-related changes in PESP in 20 consecutive patients (age, 65-89 years) with significant AS (aortic area less than or equal to 1.0 cm(2)) on cardiac catheterization with VE on AVG pressure recording. Hemodynamics and LV systolic time intervals were averaged from three consecutive beats and from the post-VE beat. Changes (Delta) in AVG, pre-ejection period/LV ejection time ratio (PEP/LVET), aortic diastolic pressures (AoDP), and LV end-diastolic pressures (LVEDP) were calculated. Age was inversely correlated with Delta AVG (r = -0.84, P = 0.0001), with Delta PEP/LVET (r = -0.87, P = 0.0001), and with Delta AoDP (r = -0.89, P = 0.0001), but not with Delta LVEDP (r = 0.23, P = 0.31). On multivariate analysis, only age was associated with Delta AVG (r(2) = 0.72, P = 0.0001). There was an age-related decline in PESP in patients with AS, which was accompanied by changes in contractile reserve and afterload reduction, but independent of preload reserve. (C) 2002 Wiley-Liss, Inc.