The right and left ventricular intracavitary and transmural pressure-strain relationships
M Traboulsi1, N W Scott-Douglas, E R Smith
1Department of Medicine, Faculty of Medicine, University of Calgary, Alberta, Canada.
Abstract:
The magnitude of pericardial pressure and therefore the shape of the right ventricular end-diastolic transmural pressure-volume relationship remains controversial. To investigate ventricular compliance, eight dogs anesthetized with fentanyl were instrumented as follows. Right and left ventricular intracavitary pressures were measured with micromanometer-tipped catheters. Right and left ventricular free wall segment lengths were measured by sonomicrometry. Pericardial pressure was measured over the right and left ventricles by means of flat liquid-containing balloon transducers, and transmural pressures were calculated as the difference between intracavitary and pericardial pressures. After defining the pressure-segment length relationship by vena caval constriction followed by release and blood transfusion, the pericardium and chest were opened widely and the cardiac volume manipulation was repeated; this allowed direct measurement of transmural right ventricular end-diastolic pressure for each level of strain recorded with the chest and pericardium closed. When intracavitary right or left ventricular end-diastolic pressure was raised from zero to 20 mm Hg, the respective transmural pressures increased from 0.2 +/- 0.6 (SD) mm Hg to 2.5 +/- 1.8 mm Hg and from 0.3 +/- 0.7 mm Hg to 6.0 +/- 2.5 mm Hg. Ventricular segmental strain increased by 7.0 +/- 0.8% and 6.0 +/- 0.2%, respectively. No statistically significant differences were found between right ventricular calculated (intracavitary minus pericardial pressure) and measured (open pericardium, open chest) transmural pressures at a given strain, thereby confirming the accuracy of our pericardial pressure measurements.(ABSTRACT TRUNCATED AT 250 WORDS)
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