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The normal pericardium does not affect left ventricular function.

S Konstadt1, D Thys, D Reich

  • 1Departments of Anesthesiology, Biomathematical Sciences, Surgery, and Medicine, Mount Sinai Medical Center, New York, NY 10029, USA.

Journal of Cardiothoracic Anesthesia
|August 1, 1987
PubMed
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The normal pericardium does not significantly impact left ventricular (LV) diastolic compliance or systolic function. This study found no measurable changes in LV performance after pericardiotomy in anesthetized patients.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Physiology

Background:

  • The role of the normal pericardium in modulating left ventricular (LV) function remains debated.
  • Understanding pericardial influence is crucial for diagnosing and managing cardiac conditions.

Purpose of the Study:

  • To investigate the constraining effect of the normal pericardium on LV diastolic compliance and systolic function.
  • To quantify changes in LV filling and performance before and after pericardiotomy.

Main Methods:

  • Utilized two-dimensional transesophageal echocardiography (2D-TEE) in 15 deeply anesthetized patients with open chests.
  • Measured end-diastolic area (EDa), end-systolic area (ESa), ejection fraction area (EFa), and hemodynamic parameters pre- and post-pericardiotomy (PC).
  • Controlled for confounding variables like surgical stimulation and autoregulation.

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Main Results:

  • No significant echocardiographic or hemodynamic alterations were observed immediately after pericardiotomy.
  • Left ventricular diastolic filling (EDa, PCWP) and systolic performance (EFa, CO) showed no significant changes post-PC.
  • While minor compliance changes cannot be entirely ruled out, they were not measurable.

Conclusions:

  • The normal pericardium does not exert a significant, measurable constraining effect on left ventricular performance.
  • LV diastolic filling and systolic function are largely independent of the intact pericardium under these experimental conditions.