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Pericardial pressure in experimental chronic heart failure
S G Horne1, I Belenkie, J V Tyberg
1Queen Elizabeth II Health Sciences Centre, Halifax, Canada. ghorne@is.dal.ca
The Canadian Journal of Cardiology
|June 2, 2000
Summary
Pericardial constraint is less significant in chronic heart failure (CHF) than previously thought, likely due to pericardial remodeling. This study measured pericardial pressure in dogs with CHF to understand its role in elevated left ventricular (LV) pressures.
Area of Science:
- Cardiology
- Physiology
Background:
- Pericardial pressure is higher than previously recognized in healthy hearts.
- Understanding pericardial constraint is crucial for heart failure research.
Purpose of the Study:
- To investigate the role of pericardial constraint in elevated left ventricular (LV) end-diastolic pressure in chronic heart failure (CHF).
Main Methods:
- Direct measurement of pericardial pressure in 11 dogs with experimentally induced CHF.
- Utilized micromanometers, pacing leads, and a pericardial balloon for pressure monitoring and manipulation.
- Assessed the impact of nitroglycerin, volume loading, and pericardiotomy on LV and pericardial pressures.
Main Results:
- In dogs with CHF, LV end-diastolic pressure was significantly higher than pericardial pressure.
- Nitroglycerin reduced both LV end-diastolic and pericardial pressures, decreasing transmural pressure.
- Volume loading increased LV end-diastolic pressure and transmural pressure, with non-significant changes in pericardial pressure.
- Opening the pericardium reduced LV end-diastolic pressure, and studies excluding epicardial scarring showed elevated LV pressures.
Conclusions:
- Pericardial constraint was less pronounced in this CHF model compared to acute models, suggesting pericardial remodeling is a key factor.
- The findings highlight the dynamic interaction between the pericardium and the left ventricle in chronic heart failure.