Key result
Simulated early-stage pericardial adhesions reduce endocardial twist by ~38% versus baseline in pigs.
Why the study?
Does the simulation of early-stage pericardial adhesions alter epicardial and endocardial LV rotational mechanics in an open-chest pig model?
Does the simulation of early-stage pericardial adhesions alter epicardial and endocardial LV rotational mechanics in an open-chest pig model?
Early-stage pericardial adhesions in a pig model reduce endocardial LV twist and torsion, suggesting selective endocardial/epicardial analysis may help diagnose early pericardial adhesions.
Answers are grounded in this paper and cite their sources.
Suggests potential diagnostic role for endocardial twist in early adhesions; leaves open human validation.
AIMS: Diagnosis of pericardial adhesions is challenging. Twisting of the left ventricle (LV) is essential for normal LV functioning. We experimentally characterized the impact of pericardial adhesions on epicardial and endocardial LV rotational mechanics with velocity vector imaging (VVI). METHODS AND RESULTS: In nine open-chest pigs, the heart was exposed while preserving the pericardium. Early-stage pericardial adhesions were simulated by instilling tissue glue to pericardial space. Using VVI, LV rotational mechanics was quantitatively assessed endocardially and epicardially along with haemodynamic data at baseline and following the experimental intervention. End-diastolic volume, ejection fraction, stroke volume, late diastolic filling velocity, and LV endocardial torsion decreased significantly. LV epicardial torsion showed only a trend towards decrease (P = 0.141). Endocardial twist and torsion decreased significantly (P = 0.007) from 8.6 +/- 2.2 degree and 1.497 +/- 0.397 degree/cm to 5.3 +/- 1.8 degree and 0.97 +/- 0.38 degree/cm, respectively; epicardial twist showed a trend towards a decrease in its magnitude. Gradients of endocardial/epicardial twist and torsion did not significantly change. CONCLUSION: The model suggests that early-stage pericardial adhesions reduce both epicardial and endocardial LV twist and torsion without a significant alteration in their transmural gradient. Selective endocardial/epicardial analysis of LV twisting mechanics may have a diagnostic role in detection of early formation of pericardial adhesions.
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Alharthi et al. (2009) studied Pericardial adhesions (n=9). Instilling tissue glue to pericardial space vs. Baseline was evaluated on Endocardial twist and torsion (p=0.007). In a pig model, simulated early-stage pericardial adhesions significantly decreased endocardial twist (from 8.6 to 5.3 degrees) and torsion (from 1.497 to 0.97 degree/cm) compared to baseline (P=0.007).
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