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November 1, 1981Circulation

Ventricular diastolic pressure-volume relations and the pericardium. Effects of changes in blood volume and pericardial effusion in dogs.

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Population

12 closed-chest anesthetized dogs instrumented with pericardial and pleural balloons and intracardiac…

Comparison

Infusion of 40 and 80 ml of dilute contrast… vs Baseline/control state

Design

Preclinical

Authors

HRH. RefsumDiakonhjemmet HospitalMJMichael JunemannUniversity of CalgaryMLMartin J. LiptonAmerican College of Cardiology

Discussion

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Implication

Pericardial constraint warrants consideration in acute hemodynamic assessments; leaves open translation beyond animal models.

Key Points

  • To determine how the pericardium mediates shifts in ventricular diastolic pressure-volume relationships during changes in circulating blood volume and acute pericardial effusion.
  • Evaluated 12 closed-chest anesthetized dogs instrumented with pericardial and pleural balloons alongside intracardiac pressure catheters.
  • Quantified left ventricular, right ventricular, and pericardial volumes using computed tomography cross-sections at 1-cm intervals from apex to aortic arch.
  • Altered cardiac loading through pericardial infusions of 40 mL and 80 mL contrast medium, acute hemorrhage, and rapid intravenous saline loading.
  • Pericardial effusion of 80 mL reduced mean right ventricular volume to 59% of control and left ventricular volume to 81% of control while increasing total pericardial pressure.
  • Saline infusions increased right atrial pressure and pericardial pressure equally by 10 to 15 mm Hg, producing an upward shift of identical magnitude in the left ventricular diastolic pressure-volume relation.
  • Transmural pressure-volume coordinates for both the left and right ventricles fell along a single curve across interventions, showing that shifts were driven by changes in pericardial pressure.

Structured PICO

P
Population
12 closed-chest anesthetized dogs instrumented with pericardial and pleural balloons and intracardiac catheters
I
Intervention
Infusion of 40 and 80 ml of dilute contrast medium into the pericardial space, bleeding, and rapid intravenous saline infusion
C
Comparator
Baseline/control state
O
Outcome
Ventricular diastolic pressure-volume relations and pericardial pressure/volumesurrogate

Acute shifts in the left ventricular diastolic pressure-volume relation during volume loading and pericardial effusion are primarily caused by changes in pericardial pressure and volume.

Cite This Study

Refsum et al. (1981) studied this question.

synapsesocial.com/papers/6a16424ef9339c53aa8eac02https://doi.org/10.1161/01.cir.64.5.997
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Myocardial interaction between the ventricles1976 · 184 citations
  2. 2The effects of geometry, elasticity, and external pressures on the diastolic pressure-volume and stiffness-stress relations. How important is the pericardium?1979 · 151 citations
  3. 3Measurement of postoperative pericardial pressure in man.1977 · 25 citations
  4. 4Diastolic Properties of the Left Ventricle1976 · 441 citations
  5. 5Altered left ventricular diastolic properties during pacing-induced ischemia in dogs with coronary stenoses. Potentiation by caffeine.1982 · 97 citations